Goldenhar's Syndrome Associated With Tamoxifen Given to the Mother During Gestation

To the Editor. —Tamoxifen citrate is a nonsteroidal antiestrogen widely used in the treatment of all stages of breast cancer. Women taking the drug are at increased risk of endometrial cancer and thromboembolic events. 1 Little is known of the effects on human pregnancy and the exposed fetus. These effects are of particular interest as tamoxifen is now being used in large chemoprevention trials in women at increased risk for breast cancer. We report an infant born with Goldenhar's syndrome (oculoauriculovertebral dysplasia) exposed to tamoxifen throughout pregnancy. Report of a Case. —A 35-year-old woman underwent a mastectomy in March 1992 for a node-negative, estrogen-receptor— negative, progesterone-receptor—positive breast cancer. She received no systemic chemotherapy and began receiving 20 mg of tamoxifen daily. In July 1993, while still receiving tamoxifen, she presented with abdominal pain and vaginal bleeding and was found to be 26 weeks' pregnant. Premature labor, chorioamnionitis, and abnormal lie