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Recent research suggests that tamoxifen can interact with cells to alter the amount of the activity of substances called growth factors. These are proteins produced and secreted by certain types of cells, which act to stimulate or inhibit the growth of breast cancer cells. It appears that tamoxifen can induce the production of at least one kind of growth factor from stromal cells, which are normal cells that surround cancerous cells in the breast tissue. The secreted protein is called transforming growth factor-beta (TGF-b).

Other studies suggest that tamoxifen is broken down in the liver to several different compounds known as tamoxifen metabolites. At least one of these metabolites, 4-hydroxytamoxifen, is more effective than tamoxifen and is thought to be responsible for the majority of tamoxifen activity in inhibiting breast cancer cell growth. Although, like tamoxifen, this metabolite binds to estrogen receptors, it has also been found to bind very tightly to other cellular proteins. These proteins are called antiestrogen binding sites, or AEBSs, and their function remains poorly understood. Further research may show that they too are involved in tamoxifen's ability to inhibit the growth of breast cancer cells.