tamoxifin and breast cancer

i suffered a stroke and several dvt blood clots in legs due to tamoxifin (tamoxifen). i was on it for 6 months, immediately taken off of it.  i had severe migraines the entire 6 months. i have damage to the valves in my legs. awful. why do they prescribe such a dangerous drug.  i had an iv cava filter put in the groain area as well. will i always have swelling to the legs?  i can"t climb stairs as my legs constantly hurt. its been 9 months since the clots. i am on cumadin (coumadin) yet, dosage floats from 7.5 to 10. what is going on with this drug?  I want my legs back to normal. is it safe to take the filter out as i have so much weight gain in the upper abdomen area as if nothing is flowing down to the legs. i also have contant indigerstion.  help

[CCF-RN,MSN-JS]

Dear wildcherry,  Whenever a drug is prescribed there is a weighting of the risks vs. benefit.  In women with estrogen receptor positive breast cancer, tamoxifen has been shown to decrease the risk of recurrence of the cancer, and reduces the chance of getting cancer in the opposite breast by 50 percent (if risk is 15 that is decreased to 7.5).  Increased risk of blood clots is a serious but rare side effect of tamoxifen.  This risk increases with age.  

As to your current problems with the treatment of the blood clots; the details of management such as appropriate length of time for coumadin therapy, specifics regarding the dosing, and  whether the filter can safely be removed are questions that can best be answered by the physicians dealing with these problems.  At our institution we often turn to our collegues in vascular medicine to advise and assist with these blood clotting issues.