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There is no clinical evidence that one is more effective than the other. Tamoxifen is used for Pre-menopausal women and the switch is made to an aromatase inhibitor after menopause (Arimidex or Femara). The purpose of all three drugs is to lessen the posibility of recurrance of ER/PR positive cancers which to me is a different meaning than "survival". I think the fact that the study was done my the manufacturer of the drug might be a clue as to it's questionable results. Some women switch between the two depending on the side effects they experience; pt.s often tolerate one better than the other. Regards ....