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In recent years, accumulating evidence suggests that oxidative stress, mitochondrial dysfunction, and disturbances in iron homeostasis serve as upstream triggers driving these pathological cascades (Luo et al., 2019

Thus, it can be said that the development of cancer is not only due to the type of habit that patients have but depends on interaction between the metabolites and the genes that detoxify these metabolites/carcinogens

This creates additional uncertainty when evaluating both safety and clinical outcomes

This cytotoxic accumulation of tamoxifen could be aided by Antiestrogen Binding Site (AEBS) to which tamoxifen has high affinity as opposed to estrogen