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Low-dose tamoxifen significantly raised sex hormone-binding globulin (SHBG) levels in women at high risk for breast cancer, outperforming lifestyle interventions in a randomized phase 2 trial. The drug also favorably shifted growth factor markers linked to cancer risk. While quality-of-life scores dipped slightly in tamoxifen groups, the differences weren't clinically meaningful — suggesting low-dose tamoxifen could be a promising prevention strategy.
A randomized phase 2 trial out of Italy found that low-dose tamoxifen — taken as 10 mg every other day — significantly raised sex hormone-binding globulin (SHBG) levels in women at high risk for breast cancer, compared to lifestyle-based interventions. The trial enrolled 110 women across four Italian centers and tested four 6-month strategies: low-dose tamoxifen, tamoxifen plus intermittent caloric restriction (the 5:2 diet), a step-counter lifestyle program, or the lifestyle program plus caloric restriction.
Beyond SHBG, tamoxifen-containing regimens also favorably altered insulin-like growth factor (IGF) system markers — reducing IGF-1 and IGFBP-2 while increasing IGFBP-1 and IGFBP-3. Intermittent caloric restriction showed a modest boost in adiponectin levels, though this didn't hold up after statistical correction. Quality-of-life scores dipped in physical, psychological, sexual, and vasomotor domains with tamoxifen, but the overall difference fell below the threshold for clinical relevance.
Key Takeaways:
Why it matters: These findings support the idea that pharmacological and behavioral interventions may complement each other in breast cancer prevention — opening the door for integrated approaches that could meaningfully reduce risk in high-risk women.
