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June 8, 1979, Vol 241, No. 23 >
ARTICLE | June 8, 1979

Tamoxifen Flare

Daniel J. Arnold, MD; Mark J. Markham, MD; Susan Hacker, MD
JAMA. 1979;241(23):2506. doi:10.1001/jama.1979.03290490018013.
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To the Editor.—  The recent article "Tamoxifen Flare in Advanced Breast Cancer" by Plotkin et al (240:2644, 1978) emphasizes an often-ignored phenomenon. We have analyzed our experience with this agent in treating 68 postmenopausal patients with advanced breast cancer. The flare phenomenon was specifically sought in a prospective fashion. Six patients experienced a transient flare of bone or soft-tissue pain. One of these flares was accompanied by mild and transient hypercalcemia. Of these six patients, two attained objective response, and one showed a subjective improvement accompanied by a lessthan-50% reduction in measurable disease. Two patients had progressive disease while receiving tamoxifen citrate. Early in the study, tamoxifen therapy was discontinued in one patient because of flare, before there was any. possibility of evaluating her response. She subsequently failed to respond to therapy with doxorubicin hydrochloride (Adriamycin) or megestral acetate (Megace) before dying of progressive disease three months after the tamoxifen

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