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Elevated hepatic enzymes, specifically increased AST levels (5% vs 3%), and hyperbilirubinemia (2% vs 1%) occurred more often in women with axillary node-negative, estrogen-receptor positive breast cancer who received adjuvant tamoxifen (n = 1422) compared with placebo (n = 1437) following primary surgery in a randomized, double-blind study (the NSABP B-14 study)

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