<s>[INST] context: Selective estrogen receptor modulators (SEAMs): Tamoxifen citrate :Though chemically related to clomiphene, it has complex actions; acts as potent estrogen antagonist in breast carcinoma cells, blood vessels and at some peripheral sites, but as paial agonist in uterus, bone, liver and pituitary. Inhibition of human breast cancer cel b and hot flushes reflect antiestrogenic action while the weak estrogen agonistic action manifests as stimulation of endometrial proliferation lowering of Gn and prolactin levels in postmenopausal women as well as improvement* in their bone density. Tamoxifen is the standard hormonal treatment of breast cancer in both pre- and post menopausal women, though aromatase inhibitors are gaining prominence. In early cases it is given as postmastectomy adjuvant therapy, while in advanced cases it is a constituent of palliative treatment. Response rates are high in ER-positive breast carcinomas, but some ER-negative tumours also respond suggesting additional nonhormonal mechanism of action. It is also effective following surgery in cancer of male breast. ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:304 [/INST] question: Which of the following is used to treat hormone-responsive breast cancer? | options: A: Adriamycin B: Clomiphene citrate C: Diethylstibestrol D: Tamoxifen | answer: D </s>