Patient and provider factors associated with the noninitiation of tamoxifen for young women at high‐risk for the development of breast cancer

We sought to identify factors associated with disparities in tamoxifen utilization among young patients at high‐risk for developing breast cancer. We identified 67 premenopausal, high‐risk women age 35‐45, without surgical prophylaxis, who did not initiate tamoxifen. Factors associated with noninitiation were examined. About 37% of patients had no documented provider‐based discussion regarding initiation. Type of high‐risk diagnosis was the only factor associated with a provider‐based discussion (P = .03). For patients offered tamoxifen, primary reasons for noninitiation were perceived minimal benefit (66.7%), fertility concerns (16.7%), and concerns about side effects (7.1%). Implementation of comprehensive educational strategies regarding the benefits of tamoxifen should be facilitated to improve initiation among young high‐risk patients.