Relevance of breast cancer hormone receptors and other factors to the efficacy of adjuvant tamoxifen: patient-level meta-analysis of randomised trials

Davies, Kelvin J.A.; Godwin, Jon; Gray, Richard; Clarke, Michael; Cutter, David J.; Darby, Sarah C.; McGale, Paul; Pan, H; Taylor, C; Wang, X; Dowsett, Mitch; Ingle, James N.; Pető, Richárd

doi:10.1016/s0140-6736(11)60993-8

Cited by 2,414 publications

(970 citation statements)

References 33 publications

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“…Thus, the effects of chemotherapy occur in the short term (≤3 years) in many cases. On the other hand, with regard to the period of treatment using adjuvant TAM, the study by the Early Breast Cancer Trialists' Collaborative Group [17] showed that in ER-positive patients, the relative risk of those receiving TAM for 5 years against those without TAM at 0-4 years was 0.53, at 5-9 years it was 0.68 and at ≥10 years it was 0.94, showing significant inhibition of recurrence up to 10 years. Furthermore, the 5- and 10-year TAM data of the ATLAS study [7] revealed that the relative risk at 5-9 years was 0.90 whereas that at ≥10 years was 0.75, showing significant reduction.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Factors Related to Late Recurrence - Later than 10 Years after the Initial Treatment - in Primary Breast Cancer

Nishimura¹,

Osako²,

Nishiyama³

et al. 2013

Oncology

9,351

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Background: Breast cancer is associated with a relatively good prognosis. Prognostic factors examined to date are related to early recurrence while those related to late recurrence and their countermeasures remain unclear. Therefore, we examined the factors related to late recurrence. Patients and Methods: From January 1980 to August 2012, 4,774 patients who underwent primary treatment and estrogen (ER) and progesterone receptor (PgR) assessment were enrolled in this study. The patients were divided into two groups, those with a follow-up period <10 years and those without any recurrence at 10 years but who continued follow-up examinations. Recurrence occurred in 711 patients followed up for <10 years and in 51 patients for ≥10 years. Results: The overall 10-year cumulative disease-free survival rate was 79.5%, and the recurrence rate at ≥10 years was 5.8%. A multivariate analysis revealed that the factors related to late recurrence were PgR positivity and positive nodes. This result differed from that for early recurrence in terms of ER/PgR, Ki-67 index and p53 overexpression. Conclusion: PgR positivity and lymph node metastases significantly correlated with late recurrence. Therefore, it is important to evaluate appropriate measures such as treatment period and treatment regimen for hormone-sensitive patients.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Factors Related to Late Recurrence - Later than 10 Years after the Initial Treatment - in Primary Breast Cancer

Nishimura¹,

Osako²,

Nishiyama³

et al. 2013

Oncology

9,351

View full text Add to dashboard Cite

show abstract

“…In hormone receptor-positive cases, tamoxifen is approved for premenopausal women to reduce recurrence rate and mortality in adjuvant therapy [24]. Of the hormone receptor-positive patients, 94.4% in the cohorts of young mothers received endocrine therapy (88.5% receiving tamoxifen) and 97.3% in the OVIS cohort, showing a high level of guideline conformity in both groups.…”

Section: Discussionmentioning

confidence: 99%

Guideline Conformity Treatment in Young Women with Early-Onset Breast Cancer in Germany

et al. 2014

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Background: The purpose of the study was to characterize the treatment of young mothers with breast cancer in Germany and to investigate whether it followed applicable guidelines. Method: Retrospective data obtained between 2002 and 2011 for 1,053 mothers with children of < 12 years of age with adjuvantly treated loco-regional primary breast cancer were analyzed. Collected data included sociodemographic data, TNM stage, biology of tumor and therapies. Actually received therapies were compared to those suggested in guideline treatment plans. Results: The mean age of the patients was 39 years. 97% of the women with node positivity received an axillary dissection. Overall, 90% of the patients received chemotherapy with a guideline adherence range of 87-99% depending on clinical parameters. For radiation therapy, guideline adherence was high (range 82-100%). 95% of the patients with a hormone receptor-positive tumor received endocrine therapy; in 94%, tamoxifen therapy was performed in compliance with guidelines, whereas gonadotropin-releasing hormone (GnRH) agonist therapy complied with the guidelines in 52% of the cases. Conclusion: Guideline adherence in young mothers with breast cancer in Germany was high (with the exception of GnRH therapy), as comorbidity or the ambiguity of the therapeutic success does not need to be considered as much in this young, otherwise usually healthy, cohort compared to an age-heterogeneous group.

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“…The benefit of adjuvant endocrine therapy was demonstrated in a large meta-analysis by the Early Breast Cancer Trialists' Collaborative Group (EBCTCG), which demonstrated a 39% decrease in breast cancer recurrence, 40% decrease in contralateral breast cancer, and a 30% decrease in breast cancer mortality, with the use of tamoxifen for 5-years compared to surgery alone [20]. A benefit was observed both in younger and older women.…”

Section: Adjuvant Endocrine Therapymentioning

confidence: 99%

Endocrine Therapy in Older Women with Early-Stage Hormone Sensitive Breast Cancer

Hsu¹,

Sud²

2017

J Gerontol Geriatr Res

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Breast cancer is the most common cancer affecting women worldwide, with the highest risk in those aged 70 and over. Most older women (80% to 85%) have hormone receptor positive breast cancer and thus the use of endocrine therapy is common in this population. Typically, women receive endocrine therapy for at least 5 years to reduce the risk of cancer recurrence and decrease breast-cancer mortality. However, adherence to hormonal therapy may be an issue, particularly in older women, as side effects may lead to early discontinuation and/or non-adherence. Older women on endocrine therapy are often cared for by primary care physicians and geriatricians and therefore, an understanding of oral endocrine therapy, as well as its potential side effects, is essential for treating physicians. This review describes the benefits of endocrine therapy in patients with resected breast cancer, compare different hormonal therapies with regards to side-effects and discuss management strategies with a particular focus on the concerns of older breast cancer patients on endocrine therapy. Mrs. Smith is a 75-year-old woman whose family doctor noted a 3 cm to 4 cm lump in her left breast during a routine physical exam. She has no palpable lymph nodes. Her family doctor sends her for a mammogram which reveals a 2.6 cm spiculated mass in the left upper outer quadrant. Biopsy reveals an invasive ductal carcinoma.

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Relevance of breast cancer hormone receptors and other factors to the efficacy of adjuvant tamoxifen: patient-level meta-analysis of randomised trials

Cited by 2,414 publications

References 33 publications

Evaluation of Factors Related to Late Recurrence - Later than 10 Years after the Initial Treatment - in Primary Breast Cancer

Evaluation of Factors Related to Late Recurrence - Later than 10 Years after the Initial Treatment - in Primary Breast Cancer

Guideline Conformity Treatment in Young Women with Early-Onset Breast Cancer in Germany

Endocrine Therapy in Older Women with Early-Stage Hormone Sensitive Breast Cancer

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