Tax Arithmetic Shows Top Rate Is Just a Starter in Talks

WASHINGTON — Despite hints in recent days that President Obama and House Speaker John A. Boehner might compromise on the tax rate to be paid by top earners, a host of other knotty tax questions could still derail a deal to avert a fiscal crisis in January.

The math shows why. Even if Republicans were to agree to Mr. Obama’s core demand — that the top marginal income rates return to the Clinton-era levels of 36 percent and 39.6 percent after Dec. 31, rather than stay at the Bush-era rates of 33 percent and 35 percent — the additional revenue would be only about a quarter of the $1.6 trillion that Mr. Obama wants to collect over 10 years. That would be about half of the $800 billion that Republicans have said they would be willing to raise.

That calculation alone suggests the scope of the other major tax issues to be negotiated beyond tax rates. And that is why many people in both parties remain unsure that a deal will come together before Jan. 1. Without agreement, more than $500 billion in automatic tax increases on all Americans and cuts in domestic and military programs will take hold, which could cause a recession if left in place for months, economists say.

“The question is making sure that we hit a revenue target that’s required for a truly balanced deficit-reduction plan,” said Representative Chris Van Hollen of Maryland, the senior Democrat on the House Budget Committee. “And when the president and all of us say this is a question of math, we mean it. It’s very hard to make the numbers work without the top rates going back to the full Clinton-era levels.”

The top tax rates are taking center stage right now because Mr. Obama believes he won a mandate after campaigning relentlessly on the idea of extending Mr. Bush’s tax cuts only for households with annual income below $250,000. But the two parties also have ideological differences on taxes affecting savings, investment and inheritance, which have flared in battles going back to the Reagan years. To get a deal in the coming weeks, those differences must be addressed at least in broad terms, even if the details are left to a battle over revamping the tax code next year.

The argument over rates is far from settled. Although the two sides seem close enough on the percentages for easy compromise, principle and politics loom large: Republicans oppose raising rates as a matter of ideology, saying that it kills jobs, and the president insists that he will not keep the Bush-era rates on income above roughly $250,000 after two campaigns in which he vowed to return them to the levels of the Clinton years.

“Just to be clear, I’m not going to sign any package that somehow prevents the top rate from going up for folks at the top 2 percent,” he said Thursday.

In recent days, comments from some Republicans, including Mr. Boehner, their chief negotiator, have hinted that the party — recognizing its weak hand — might be moving toward a concession on tax rates. Seldom mentioned is that Mr. Obama’s revenue total also reflects four other changes from Bush-era tax cuts: higher tax rates on investment income from capital gains and dividends, and the restoration of two other Clinton-era provisions limiting deductions and tax exemptions for affluent individuals.

Together those changes would raise $407.4 billion over a decade — nearly as much as the president’s proposal on higher rates, which would raise $441.6 billion by 2023, for a total of $849 billion. Another $119 billion would come from higher estate taxes, opposed by Republicans and some Democrats.

And both the president and Republicans are committed to raising hundreds of billions of dollars by overhauling the tax code to further limit or end the tax breaks that high-income taxpayers can claim, though they differ in how to do that.

Republicans want to raise all $800 billion from overhauling the tax code, erasing tax breaks for high-income households and using the new revenues both to reduce deficits and to lower everyone’s tax rates. But they have not proposed how to do that, and the president insists it cannot be done without hitting middle-income taxpayers.

Mr. Obama has proposed to keep existing tax breaks but to limit the rate of those breaks for people in higher tax brackets to 28 percent, which would raise $584 billion in a decade. He has proposed variations of that proposal for four years, only to be ignored by both parties because of opposition from charitable groups, the housing industry, insurers and others to curbing deductions for charitable giving, mortgage insurance and other purposes.

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Afghan Spy Chief’s Attacker Hid Bomb by His Groin

KABUL, Afghanistan — The man who tried to kill Afghanistan’s intelligence chief this week by smuggling a bomb into a guesthouse in Kabul concealed the device “around his groin,” according to a statement released Friday by the government. The statement suggested one reason the bomb might not have been detected during a search.

It called the bombing, which seriously wounded the intelligence director, Asadullah Khalid, “unethical and contrary to principles of Shariah law.”

Shafiqullah Taheri, a spokesman for the National Directorate of Security, the agency headed by Mr. Khalid, said, “It is degrading and insulting to search anyone’s genital area, according to Shariah law.”

The spy agency has not said whether the bomber was searched when he entered the guesthouse on Thursday, where Mr. Khalid was meeting with the head of another government agency.

But if he were searched, the bomber would have forced any security guard who wanted to do his job thoroughly to behave in an un-Islamic fashion and intrude on an area of the body that is usually off limits to anyone other than a very close relative.

The only other information released Friday by the government was that Mr. Khalid, who is in his early 40s, was recovering. Western officials with some knowledge of the case said that while he would survive, he had serious abdominal injuries that would require multiple operations and that it was not yet clear if or when he would be able to return to work. The Taliban have claimed responsibility for the attack.

President Hamid Karzai visited Mr. Khalid on Thursday at a hospital run by the security directorate where he was initially taken, and Gen. John R. Allen, the commander of the international coalition forces in Afghanistan, visited him on Friday at the Bagram Air Base hospital where he was transferred late Thursday.

Other than the location of the bomb, the intelligence agency said little about the attack and released no information about the attacker, including whether he had died in the explosion or had been shot by a guard.

The directorate’s statement about the location of the bomb seemed in part to be a response to questions from the public about how a suicide bomber was able to get so close to Mr. Khalid without being detected.

Afghans have found the notion of security searches, which are routine in the West, extremely difficult to embrace from a religious and a cultural perspective. Muslim cultures generally place great emphasis on modesty, and men and women are reluctant to show any parts of their bodies to strangers. While different schools of Islamic law have somewhat different teachings, revealing any part of the body and touching anyone else’s body is restricted.

In Afghanistan’s extremely conservative culture, a sense of discretion runs even deeper. Even at the height of summer, most Afghan men do not wear shorts; if they were to, the shorts would be knee-length. Outside major cities, a vast majority of women would not leave their homes without wearing a burqa, a veil that completely hides the face and body.

Gradually, searches in Afghanistan have become more thorough as suicide bombers wearing explosive vests have become more prevalent. Afghan security forces have tried to inculcate a more Western approach to searches among their guards, but it has not been easy.

A number of Afghans regard a body search as an insult signifying a lack of trust. So if the bomber who tried to assassinate Mr. Khalid was being brought to meet him by a trusted person, guards might well have been reluctant to offend him with a thorough body search.

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The Era of Twitter Without Instagram Has Now Begun

We know everyone is a little bummed about all those filtered photos disappearing from your Twitter streams this weekend, but let’s not get all worked up about it: They are disappearing, and there is no scandal.

RELATED: Why You Can’t See Instagram Photos on Twitter Anymore

TechCrunch’s  Drew Olanoff got a little too excited on Friday and thought a single in-stream photo meant that Instagram was allowing its Twitter cards back on Twitter and thought the two services were planning a sudden reunion. You may have seen some, too, but a Facebook spokesperson assured users these Instagram photos on Twitter were the last holdouts in the switchover. ”What you are seeing now may be some sort of regression depending on the mobile client, but we’re checking in with the engineers,” read Facebook’s statement, via Talking Points Memo’s Carl Franzen.

RELATED: How to Get Over the Twitter-Instagram War on Photos

Which means the end of this particular social-media marriage is upon us. Despite the immediate user backlash, Instagram CEO Kevin Systrom has made it pretty clear that the photo-sharing app doesn’t plan on making nice with Twitter. In case you hadn’t accepted the reality of Silicon Valley competition the first time around, this photo-friendly weekend might be the time to check out our handy three-step guide to getting over it. 

Social Media News Headlines – Yahoo! News

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Te'o and Manziel hit Manhattan with Heisman hopes

NEW YORK (AP) — Notre Dame linebacker Manti Te'o was looking forward to a break. It's been a long week for most decorated football player in the country.

Texas A&M quarterback Johnny Manziel seemed to have more energy when he arrived at a midtown Manhattan hotel with his fellow Heisman Trophy finalist.

The two players spent about 30 minutes getting grilled by dozens of reporters before being whisked away to more interviews.

Manziel, Te'o or Collin Klein, the other finalist — who could not make it to town Friday — each has a chance to be a Heisman first Saturday night.

Manziel is trying to be the first freshman to win the award. Te'o would be the first winner to play only defense. Klein would be Kansas State's first Heisman winner.

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The New Old Age Blog: A Son Lost, a Mother Found

My friend Yvonne was already at the front door when I woke, so at first I didn’t realize that my mother was missing.

It was less than a week after my son Spencer died. Since that day, a constant stream of friends had been coming and going, bringing casseroles and soup, love, support and chatter. Mom hated it.

My 94-year-old mother, who has vascular dementia, has been living in my home in upstate New York for the past few years. Like many with dementia, mom is courteous but, underneath, irascible. Pride defines her, especially pride in her Phi Beta Kappa intellect. She hates to be confronted with how she has become, as she calls it, “stupid.”

The parade of strangers confused her. She had to be polite, field solicitous questions, endure mundane comments. She could not remember what was going on or why people were there. It must have been stressful and annoying.

That night, like every night since the state troopers brought the news, I woke hourly, tumbling in panic. As if it were not too late to save my son. Mom knew something was wrong, but she could not remember what. As I overslept that morning, she must have decided enough was enough. She was going home.

In a cold sky, the sun blazed over tall pines. As I opened the door, the dogs raced out to greet Yvonne and her two housecleaners. Yvonne often brags about her cleaning duo. They were her gift to me. They were going to clean my house before the funeral reception, which was scheduled for later that week. This was a very big gift because, like my mother before me, I am a very bad housekeeper.

Mom’s door was shut. I cautioned the housecleaners to avoid her room as I showed them around. Yvonne went to the kitchen to listen to the 37 unheard messages on my answering machine; the housecleaners went out to their van to get their instruments of dirt removal.

I ducked into Mom’s room to warn her about the upcoming noise. The bed was unmade; the floor was littered with crumpled tissues; the room was empty.

Normally, I would have freaked out right then. I knew Mom was not in the house, because I had just shown the whole house to the cleaners. Although Mom doesn’t wander like some dementia patients, she does on occasion run away. But I could not muster a shred of anxiety.

“Yvonne,” I called, “did you see my mother outside?”

Yvonne popped her head into the living room, eyebrows raised.“Outside? No!” She was alarmed. “Is she missing?”

“Yeah,” I said wearily, “I’ll look.” I stepped out onto the front porch, tightening the belt of my bathrobe and turning up the collar. Maybe she had walked off into the woods. The dogs danced around my legs, wanting breakfast.

I had no space left in my body to care. Either we would find her, or we would not. Either she was alive, or she was not. My child was gone. How could I care about anything ever again?

Then I saw my car was missing. My mouth fell open and my eyeballs rolled up to the right, gazing blindly at the abandoned bird’s nest on top of the porch light: What had I done with the keys?

Mom likes to run away in the car when she is angry. She used to do it a lot when my father was still alive — every time they fought. Since Mom took off in my car almost a year ago, after we had had a fight, I’d kept the keys hidden. Except for this week; this week, I had forgotten.

I was reverting to old habits. I had left the doors unlocked and the keys in the cupholder next to the driver’s seat. Exactly like Mom used to do.

“Uh-oh,” I said aloud. Mom was still capable of driving, even though she did not know where she was going. I just really, really hoped that she didn’t hurt anybody on the road. I pulled out my cellphone, about to call the police.

“Celia!” Yvonne shouted from the kitchen. She hurried up behind me, excited. “They found your mother. There are two messages on your machine.”

At that very moment, Mom was holed up at the College Diner in New Paltz, a 20-minute drive over the mountain, through the fields, left over the Wallkill River and away down Main Street.

Yvonne called the diner. They promised to keep the car keys until someone arrived. By that time, Yvonne had to go to work. She drove my friend Elizabeth to the diner, and Elizabeth drove Mom home in my car.

Half an hour later, they walked in the front door. Mom’s cheeks were rouged by the chill air and her eyes sparkled, her white hair riffing with static electricity. “Hello, hello,” she sang out. “Here we are.” She was wearing the flannel nightgown and robe I had dressed her in the night before. It was covered by her oversized purple parka, and her bare feet were shoved into sneakers.

I started laughing as soon as I saw her. I couldn’t help it. Elizabeth and Mom started laughing too. “You had a big adventure,” I said, hugging them both. “How are you?”

“I’m just marvelous,” said my mother. Mom always feels great after doing something rakish. We settled her on the sofa with her feet on the ottoman. By the time I got her blanket tucked in around her shoulders, she had fallen asleep.

Elizabeth couldn’t stop laughing as she described the scene. “Your mother was holding court in this big booth. She was sitting there in her nightgown and her parka, talking to everybody, with this plate of toast and coffee and, like, three of the staff hovering around her.”

The waitress said Mom seemed “a little disoriented” when she got there. Mom said she was meeting a friend for breakfast, but since she was wearing a nightgown and didn’t know whom she was meeting or where she lived, the staff thought there might be a problem. They convinced Mom to let them look in the glove compartment of the car, where they found my name and number.

It was then that I realized I was laughing – something I’d thought I would never be able to do again. “Elizabeth, Elizabeth, I’m laughing,” I said.

“Ha, ha, ha,” laughed Elizabeth, holding her belly.

“Ha, ha, ha,” I laughed, rolling on the floor.

And she who gave me life, who had suffered the death of my child and the extinction of her own intellect, snoozed on: oblivious, jubilant, still herself, still mine.

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Off the Charts: European Banks Thriving as Investor Fears Ease

THE European bank crisis was one of the major worries of 2012. There were forecasts that the euro zone would break up, that various countries would default on their debts and that undercapitalized banks would fail because national governments could not afford to keep them alive.

The bank crisis is not yet resolved, but it “appears to have been put on the back burner of investor concerns,” Jeffrey Yale Rubin and Kevin Pleines of Birinyi Associates said in a research bulletin sent to clients this week.

The accompanying charts show what has happened to the share prices of an index of euro zone bank stocks, and to each of the 28 members in the index, since June 30. In early July, the index kept falling, but by late in the month it turned around. Anyone who bought all the banks at the end of June is up by about 25 percent. Anyone with the good fortune to buy at the exact bottom has a profit of about half the money invested.

The bank stocks have outperformed other European stocks and they have outperformed American bank stocks, although the shares of most American banks also have risen.

The reasons for the relaxation of investor fears are simple enough. There is a growing confidence that euro zone institutions will succeed in their support efforts. Finance ministers are still arguing about the details of a single regulator for banks throughout the zone, but the European Central Bank’s promise to lend money to banks that need it is widely accepted, and investors believe that Germany will put up whatever money is needed to keep the euro zone from breaking up.

Troubled governments like Italy and Spain are still paying much more than Germany to borrow, but their rates have fallen. Costs have declined even in Portugal, which is in the weakest position of countries other than Greece. The French banks led the way up in late 2012, but even the price of Banco Espirito, a Portuguese bank, has soared by about half since midyear. There are still major concerns about troubled Spanish banks, and two of those join an Italian institution in being the only stock market losers over the period. But the National Bank of Greece managed a small gain.

None of this means that those banks have served long-term shareholders well. Only one of them, a Finnish institution, has a share price higher than it did at the end of 2007, before the financial crisis.

But, for now at least, investors seem to have growing confidence that the banks will survive. Given the fears of a few months ago, that is reason for celebration.

Floyd Norris comments on finance and the economy at nytimes.com/economix.

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IHT Rendezvous: Trust Women Conference: A Delegate's Reflections

LONDON — The first Trust Women conference, hosted by Thomson Reuters Foundation and the International Herald Tribune in London this week, boasted an impressive line up of speakers — from Melanne Verveer, the U.S. ambassador-at-large for global women’s issues to Christy Turlington Burns of Every Mother Counts to Queen Noor of Jordan, to name a few.

The conference confronted difficult subjects like modern-day slavery, the role of women after the Arab Spring, child marriage, corruption and development. The opening speech was delivered by Daw Aung San Suu Kyi by video.

When she was small, she said, growing up with her widowed mother, she thought women ruled the world. The Burmese politician, the second woman in history to be awarded the Nobel Peace Prize, said she couldn’t empathize more with the title of the conference “Trust Women.” “We women have to learn to trust ourselves much more than society has perhaps allowed us to do,” she said.

Sessions on how to change laws, enforce existing laws and change mindsets to empower women led inevitably to discussion of the role women themselves play in passing their predicament on to future generations. Shirin Ebadi, the Iranian lawyer and human rights activist featured in my film “Lili’s Journey,” said, “Men are children of women, they are raised by women, and often these notions of patriarchy are carried from generation to generation even more fiercely by the women themselves.”

Dr. Ebadi, also a Nobel Peace Prize laureate, has set out with volunteers to collect one million signatures in Iran to address the gender discrimination laws in the country’s constitution. “The aim is not to simply gather these million signatures, but to engage the entire society so that they themselves can be the change from within.”

“We tell them useful facts, unbeknownst to many like: Did you know that in an accident, the law dictates that compensation for your male counterpart will be twice the amount of yours?”

Nazir Afzal, Britain’s chief crown prosecutor for the northwest, told the conference that he was on a drive to bring those guilty of “the organized crime that is honor killing” to justice.

Most shockingly, he explained to the audience that a missing underage girl in Britain who is forced into marriage and sent back to her parents’ native country is not protected by the laws of the Western country in which she was born.

He noted of such girls, “Nobody looks for them when they go missing. When your own family is at the origin of the harm that is being done to you, there is no one else to ring the alarm bell for them.”

Home-grown grass-roots action and leadership is needed to change some of these vast issues in different cultures, which are intrinsically linked to strong traditions.
And while the concept of the “white savior complex” crossed a few minds at the conference, it was very obvious that the activists represented today need support but are deemed best placed to know how far to stretch their own communities, challenging their own specific circumstances and heritage.

They are not expecting anybody else to do it for them. Mabel van Oranje, senior adviser to the group of global leaders known as The Elders, said, for instance, that “in the African countries where we are active, we are often told to keep our nose out, but the word of Desmond Tutu, the word of Kofi Annan is highly respected … to
them, it is the voice that comes from within” Africa.

The panel on the role of women and the Arab Spring brought out some of these perspectives. When the journalist Katrin Bennhold of the International Herald Tribune asked the panel of women from Tunisia, Saudi Arabia, Libya, Yemen, Bahrain and Egypt whether they perceive Western women to be charging around with notions of what is best for them, the answer was rather candid.

“We are not here to import Western laws,” said Alaa Murabit, the founder of Voice of Libyan Women. Then she added, “We need a more accurate interpretation of the Shariah law to establish our new constitution.”

The comment upset an Iranian delegate who begged for clarification on what exactly it meant for women to be subjected to Shariah. What is the provision for women in a correct interpretation of Shariah law when it comes to gender equality, access to your children and to financial independence? The outburst threw a lot of questions into the air. They remained unanswered.

Personally, since producing my film, “Lili’s Journey,” on women’s empowerment, I am compelled by the topic of public-private partnerships to achieve some of the important development goals broached during the conference.

At the end of a two-day meeting that created dozens of new connections, fresh stories and much determination to act, Emma Bonino took the stage — epitomizing all that energy, and vowing to take it to Yangon, where she plans to spend time over the Christmas holidays with Aung San Suu Kyi. Who knows, she speculated, perhaps we can go there next year?

Noting that much of the conference had dwelled on how to empower women and get things moving in Africa, Asia or the Middle East, Emma reminded everyone in no uncertain fashion that ”we in Europe still have a very, very long way to go.”

The latest example, she said, was the failure to get a woman on to the board of the European Central Bank. Comparing the many struggles faced by women today to one of her first campaigns — to legalize abortion in Italy in the 1970s — she urged everyone present to stay focused, and to fight for laws because they do make a difference. They are the first step to ensuring that achievements are ”set in stone,” so ”that there is no going back,” she insisted, recalling the joy she had felt when abortion was allowed in Italy, that she was no longer someone campaigning for something illegal, but working to make something that was legal work well.

Activists should remember, she added, that it is important to ask governments, politicians and other individuals and institutions to do their social duty. ”We must pretend that institutions are capable of reacting to the needs of people,” she said. ”We must mob them….The more we leave them alone, the happier they are!”

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Laetitia Belmadani is a Paris-based writer and film director.

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Zynga moves to enter US gambling market

NEW YORK (AP) — Online games company Zynga said it has asked Nevada gambling regulators for a decision that could pave the way for it to enter the U.S. gambling market.

This follows Zynga’s October disclosure that it has signed a deal to offer online poker and casino games, played with real money, in the U.K. It plans to launch those games in the first half of 2013.

Zynga Inc. said in an email late Wednesday that it is seeking an “application for a preliminary finding of suitability” from the Nevada Gaming Control Board. This, the company says, is part of its plan to enter regulated “real-money gaming,” that is, gambling markets.

Zynga has not said what it plans to do with a gaming license. But the company, whose games are played primarily on Facebook, has faltered in recent months and is looking for additional revenue sources beyond online games such as “FarmVille 2″ and “Words With Friends.”

The San Francisco-based company says the process with Nevada regulators should take 12 to 18 months. If Zynga passes the first regulatory hurdle, it can then apply for a gaming license in the state. That, the company said, takes two to three months.

Zynga’s stock rose 17 cents, or 7.1 percent, to close Thursday at $ 2.49. The company went public about a year ago, when its stock priced at $ 10 per share.

Gaming News Headlines – Yahoo! News

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NHL labor talks break off after 1 hour

NEW YORK (AP) — Talks in the NHL labor fight broke down after just one hour Thursday night, and it isn't known when the league and the players' association would get back together.

After several hours of waiting for discussions to resume for a third straight day, the conversations didn't go well and had none of the momentum that existed Tuesday and Wednesday.

NHL deputy commissioner Bill Daly left the site of the negotiations and headed to the league's office.

The union held internal discussions most of the day, while keeping in contact with the NHL, and the sides finally reconvened around 5 p.m.

Players' association executive director Donald Fehr was expected to address reporters to give an update. Fehr rejoined the negotiations Thursday after sitting out the previous two days. NHL Commissioner Gary Bettman stayed out for the third consecutive day.

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Extended Use of Breast Cancer Drug Suggested

The widely prescribed drug tamoxifen already plays a major role in reducing the risk of death from breast cancer. But a new study suggests that women should be taking the drug for twice as long as is now customary, a finding that could upend the standard that has been in place for about 15 years.

In the study, patients who continued taking tamoxifen for 10 years were less likely to have the cancer come back or to die from the disease than women who took the drug for only five years, the current standard of care.

“Certainly, the advice to stop in five years should not stand,” said Prof. Richard Peto, a medical statistician at Oxford University and senior author of the study, which was published in The Lancet on Wednesday and presented at the San Antonio Breast Cancer Symposium.

Breast cancer specialists not involved in the study said the results could have the biggest impact on premenopausal women, who account for a fifth to a quarter of new breast cancer cases. Postmenopausal women tend to take different drugs, but some experts said the results suggest that those drugs might be taken for a longer duration as well.

“We’ve been waiting for this result,” said Dr. Robert W. Carlson, a professor of medicine at Stanford University. “I think it is especially practice-changing in premenopausal women because the results do favor a 10-year regimen.”

Dr. Eric P. Winer, chief of women’s cancers at the Dana-Farber Cancer Institute in Boston, said that even women who completed their five years of tamoxifen months or years ago might consider starting on the drug again.

Tamoxifen blocks the effect of the hormone estrogen, which fuels tumor growth in estrogen receptor-positive cancers that account for about 65 percent of cases in premenopausal women. Some small studies in the 1990s suggested that there was no benefit to using tamoxifen longer than five years, so that has been the standard.

About 227,000 cases of breast cancer are diagnosed each year in the United States, and an estimated 30,000 of them are in premenopausal women with estrogen receptor-positive cancer and prime candidates for tamoxifen. But postmenopausal women also take tamoxifen if they cannot tolerate the alternative drugs, known as aromatase inhibitors.

The new study, known as Atlas, included nearly 7,000 women with ER-positive disease who had completed five years of tamoxifen. They came from about three dozen countries. Half were chosen at random to take the drug another five years, while the others were told to stop.

In the group assigned to take tamoxifen for 10 years, 21.4 percent had a recurrence of breast cancer in the ensuing 10 years, meaning the period 5 to 14 years after their diagnoses. The recurrence rate for those who took only five years of tamoxifen was 25.1 percent.

About 12.2 percent of those in the 10-year treatment group died from breast cancer, compared with 15 percent for those in the control group.

There was virtually no difference in death and recurrence between the two groups during the five years of extra tamoxifen. The difference came in later years, suggesting that tamoxifen has a carry-over effect that lasts long after women stop taking it.

Whether these differences are big enough to cause women to take the drug for twice as long remains to be seen.

“The treatment effect is real, but it’s modest,” said Dr. Paul E. Goss, director of breast cancer research at the Massachusetts General Hospital.

Tamoxifen has side effects, including endometrial cancer, blood clots and hot flashes, which cause many women to stop taking the drug. In the Atlas trial, it appears that roughly 40 percent of the patients assigned to take tamoxifen for the additional five years stopped prematurely.

Some 3.1 percent of those taking the extra five years of tamoxifen got endometrial cancer versus 1.6 percent in the control group. However, only 0.6 percent of those in the longer treatment group died from endometrial cancer or pulmonary blood clots, compared with 0.4 percent in the control group.

“Over all, the benefits of extended tamoxifen seemed to outweigh the risks substantially,” Trevor J. Powles of the Cancer Center London, said in a commentary published by The Lancet.

Dr. Judy E. Garber, director of the Center for Cancer Genetics and Prevention at Dana-Farber, said many women have a love-hate relationship with hormone therapies.

“They don’t feel well on them, but it’s their safety net,” said Dr. Garber, who added that the news would be welcomed by many patients who would like to stay on the drug. “I have patients who agonize about this, people who are coming to the end of their tamoxifen.”

Emily Behrend, who is a few months from finishing her five years on tamoxifen, said she would definitely consider another five years. “If it can keep the cancer away, I’m all for it,” said Ms. Behrend, 39, a single mother in Tomball, Tex. She is taking the antidepressant Effexor to help control the night sweats and hot flashes caused by tamoxifen.

Cost is not considered a huge barrier to taking tamoxifen longer because the drug can be obtained for less than $200 a year.

The results, while answering one question, raise many new ones, including whether even more than 10 years of treatment would be better still.

Perhaps the most important question is what the results mean for postmenopausal women. Even many women who are premenopausal at the time of diagnosis will pass through menopause by the time they finish their first five years of tamoxifen, or will have been pushed into menopause by chemotherapy.

Postmenopausal patients tend to take aromatase inhibitors like anastrozole or letrozole, which are more effective than tamoxifen at preventing breast cancer recurrence, though they do not work for premenopausal women.

Mr. Peto said he thought the results of the Atlas study would “apply to endocrine therapy in general,” meaning that 10 years of an aromatase inhibitor would be better than five years. Other doctors were not so sure.

The Atlas study was paid for by various organizations including the United States Army, the British government and AstraZeneca, which makes the brand-name version of tamoxifen.

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