Tamoxifen is unproved for gynaecomastia

doi:10.1136/bmj.327.7422.1050-b

BMJ 2003;327:1050 (1 November), doi:10.1136/bmj.327.7422.1050-b

Letter

Tamoxifen is unproved for gynaecomastia

The first 100% of the full text of this article appears below.

EDITOR—We were amazed at Khan and Blamey's recommendationof tamoxifen as first line treatment of gynaecomastia.¹ Thisdrug does not have a product licence for such treatment. Theevidence base for their conclusion is small (135 patients) andis certainly not derived from randomised controlled clinicaltrials.

Gynaecomastia is most common in pubertal boys, in whom the conditionis usually self-limiting,² and data are insufficient to showthat tamoxifen is safe in this group of patients. Many questionsremain unanswered.

What effect does it have on bone growth? Does the gynaecomastiacome back after stopping treatment? What is the optimum durationof treatment?

This editorial is misleading, and until more evidence showsthat tamoxifen is safe in this condition it should not be recommendedas first line treatment, especially in pubertal boys.

Julie C Doughty, honorary senior lecturer

dr37d@udcf.gla.ac.uk

Christopher R Wilson, consultant surgeon

Department of Surgery, Western Infirmary, Glasgow G11 6NT

Competing interests: None declared

Khan HN, Blamey RW. Endocrine treatment of physiological gynaecomastia. BMJ 2003;327: 301-2. (9 August.)[Free Full Text]
Nydick M, Bustos J, Dale J H, Rawson RW. Gynaecomastia in adolescent boys. JAMA 1961;178: 449-557.[Medline]