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The B- 14 data indicate that 5 years of tamoxifen significantly reduces the incidence of new primary breast cancers in the contralateral breast (52 versus 29 events), and that 10 years of tamoxifen provides no additional benefit over and above this reduction.

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Tamoxifen downregulation of miR-451 increases 14-3-3ζ and promotes breast cancer cell survival and endocrine resistance.

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Point out that the recommendations are based on recent data from long-term tamoxifen studies, showing a "modest" survival improvement and a lower risk of ipsilateral recurrence and contralateral breast cancer.

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