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For many reasons, some people with breast cancer take a temporary break from hormone therapy such as tamoxifen (sold as Soltamox). Others decide to stop treatment earlier than planned.
Researchers may define it as taking a break, stopping early, or simply not sticking to treatment, but studies have found that it’s not uncommon for people to stop tamoxifen before completing the recommended course.
Whether you want a short break from bothersome side effects or high costs, are experiencing serious health complications, or you’re planning a pregnancy, it’s important to get all the facts before you consider stopping your medication.
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Here’s what you need to know about when, why, and what to expect from stopping tamoxifen.
Tamoxifen is a breast cancer treatment used to prevent cancer from recurring (returning). Many people take this hormonal therapy for five to 10 years to treat or prevent certain types of breast cancer.
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How long your oncologist recommends you take tamoxifen depends on factors such as:
Tamoxifen can decrease the risk of breast cancer recurring or new breast cancer developing by 30 percent to 50 percent. For many people, this potential benefit is well worth continuing to take tamoxifen.
Tamoxifen can decrease the risk of breast cancer recurring or new breast cancer developing by 30 percent to 50 percent.Tamoxifen works by blocking the effect of estrogen on hormone receptor-positive breast cancer. In this type of cancer, estrogen can encourage breast cancer cells to grow and divide. By blocking its effect, tamoxifen can slow or stop cancer cell growth.
You may be prescribed tamoxifen if:
Tamoxifen can be taken whether or not you have gone through menopause.
One survey of 32 women found that those who stopped taking their hormone therapy usually did so one to two years after it was prescribed. People might decide to temporarily or even permanently stop using tamoxifen for many reasons.
Tamoxifen can have side effects that affect your day-to-day life. Some common side effects that you may find difficult to manage include:
Some people may stop taking tamoxifen to feel normal again.
One MyBCTeam member said, “I’m currently on a one-month break and feeling much better! The weight gain was too overwhelming for me. I felt miserable all the time. I’m just now realizing the bone/joint pain was stemming from the tamoxifen.”
If you stop tamoxifen to get a break from side effects, you should be aware that they may not fade right away. In fact, fatigue can linger for weeks or months after you stop tamoxifen.
If you stop tamoxifen to get a break from side effects, they may not fade right away.Some side effects may begin to improve within a few weeks, while others can take several months to get better. Factors such as how long you took tamoxifen and your overall health may play a role.
Some studies have found that certain tamoxifen side effects such as hot flashes may be linked with better outcomes in some people with breast cancer. However, side effects aren’t a reliable way to tell whether tamoxifen is working. In the same way, not having side effects doesn’t mean it isn’t working.
If you experience side effects while taking tamoxifen, it’s important to talk to your cancer care team about ways to manage them. Never stop taking your medication without talking to your doctor first.
Some people stop taking tamoxifen if they have a serious or life-threatening side effect. Tamoxifen can increase your risk of uterine cancer, blood clots, and stroke.
You should talk to your doctor right away if you experience any of the following symptoms:
In rare situations, some people with metastatic breast cancer (especially cancer that has spread to the bones) may experience a temporary worsening of symptoms shortly after starting hormone therapy. This is called a tumor flare.
A tumor flare can cause increased bone pain and, in some cases, high calcium levels in the blood. Tumor flare is uncommon, and treatment may involve supportive care and close monitoring. If it occurs, your oncology team will determine whether any changes to treatment are needed.
Tamoxifen is usually the first choice of hormonal therapy for people with hormone receptor-positive breast cancer who haven’t gone through menopause yet. This includes those who may wish to have children.
However, tamoxifen is harmful to the developing child if taken during pregnancy. Individuals with breast cancer taking tamoxifen may choose to take a break to get pregnant.
A 2023 study found that some younger people could safely take a break from hormonal therapy to have a baby. The study included women younger than 42 years who were previously diagnosed with early-stage breast cancer, had been taking hormonal therapy for one-and-a-half to two-and-a-half years, and wished to become pregnant.
Researchers found that the short-term risk of breast cancer recurrence didn’t increase during the pause to have a baby. However, more studies are needed to learn if the break in therapy will affect long-term risk.
Prescriptions can be expensive. If you have a financial hardship or lose insurance coverage, it may be hard for you to pay for tamoxifen. Talk with your doctor or pharmacist about resources that may be available to help you pay for your medication.
If you stop taking tamoxifen, you may have an increased risk of breast cancer recurrence. Taking tamoxifen for the prescribed length of time can lower your risk of recurrence by up to 50 percent and decrease your risk of dying from breast cancer by 30 percent.
Never stop taking your medication without talking to your oncologist first. They can help you weigh potential benefits against the risks.Some people ask, “What happens when you stop taking tamoxifen for a week?” A short interruption may not have the same impact as stopping treatment for months or permanently, but it’s still important to let your cancer care team know. Even brief breaks should be discussed with your doctor so they can help you understand any potential risks and decide when to restart treatment.
Although stopping tamoxifen may improve your side effects, talk to your doctor before you stop taking it. Your oncologist may be able to suggest ways to improve your side effects, and you can make a shared decision about your treatment plan.
If you take a break from tamoxifen, your doctor can help you weigh the potential benefits and risks of restarting tamoxifen or another type of hormone therapy. In most cases, you can still lower your risk of breast cancer recurrence if you restart your treatment.
If you can’t take tamoxifen, you may be able to take a different type of hormonal therapy called an aromatase inhibitor. Instead of blocking the effect of estrogen, as tamoxifen does, these drugs stop your body from making estrogen.
Examples of aromatase inhibitors include:
Aromatase inhibitors are generally used in people who are postmenopausal. People who have not gone through menopause may sometimes use an aromatase inhibitor but usually only when it’s combined with ovarian suppression treatment, because the ovaries can continue making estrogen before menopause. Your doctor will consider your menopausal status and treatment goals before recommending a switch.
Aromatase inhibitors and tamoxifen can also cause some similar side effects, such as hot flashes, but also some different ones. Aromatase inhibitors don’t increase your risk of uterine cancer and very rarely cause blood clots. However, they do commonly cause muscle and joint pain.
Remember that it’s never a good idea to stop taking any medication without speaking to your care team first. They can help you evaluate your options and find alternatives in many cases.
On MyBCTeam, people share their experiences with breast cancer, get advice, and find support from others who understand.
Have you taken a break from tamoxifen? Did you restart tamoxifen or another hormonal therapy? Let others know in the comments below.
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I only take 10 mg of tamoxifen, not 20mg, and I’m 2&1/2 years in, the side effects are somewhat milder, joint pain is a little less, but the weight gain is counterproductive, because estrogen is made… read more
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