Tamoxifen Hormonal Effects

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To the editor: The report by Patterson and colleagues in the December issue (1) provides access to clinical data on adverse drug effects occasionally reported in association with tamoxifen use, but unfortunately is subject to the well-recognized limitations of ascertainment bias produced by a spectrum of factors (frequency of specific sampling for hypercalcemia, tumor estradiol receptor status, inclination to report or register the adverse effect, and so on). More important, however, their perspective neglects certain fundamental, current concepts in the molecular endocrinology of hormone action. These concepts may clarify some of the ostensibly confusing and seemingly unrelated effects occasionally noted

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