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July 6, 1979, Vol 242, No. 1 >
ARTICLE | July 6, 1979

Tamoxifen Flare

Howard W. Wallach, MD; Mark E. Oren, MD
JAMA. 1979;242(1):27. doi:10.1001/jama.1979.03300010019014.
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ABSTRACT

To the Editor.—  We have read the article by Plotkin et al in The Journal (240:2644, 1979) regarding a flare from tamoxifen used in patients with breast cancer. We have also experienced this complication in greater numbers than earlier information suggested.As Plotkin and associates point out, the increased, sometimes excruciating pain occurs within the first seven to ten days of use and often will lead to discontinuation either by the patient or by the physician.Our first several patients who experienced this flare were given steroid therapy, usually prednisone, 5 to 10 mg/day for seven to ten days. Even with continuation of the tamoxifen, the patients' pain quickly abated, and they were able to resume their previous activity and improve their activity level. They had a remission from the tamoxifen. We are not sure how the steroid affects the tamoxifen flare; it could be that the patients who respond

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