Tamoxifen: Surgery in older women with breast cancer followed by tamoxifen provides no difference in survival than tamoxifen alone, says five-year randomized study in 476 women. Article updated July 12, 2011
July 12, 2011: I'm cancer-current to revise this study came from a surprising conclusion that can take it. But read for yourself.
September 10, 2004: Source: PubMed: Ann Oncol. March 2003, 14 (3) :414-20.
Surgery in older women with breast cancer followed by tamoxifen provides no difference in survival than tamoxifen alone. Thus a five-year randomized study in 476 women. Conclusion of the authors is that in older women minimized to undergo surgery followed by tamoxifen - or other hormone treatments already better results than tamoxifen - see -breast cancers . It is worth noting that this study has been conducted from 1987 to 1992 and was published only in 2003. Below the abstract of the study.
Tamoxifen alone versus adjuvant tamoxifen for operable breast cancer of the elderly: long-term results of the Phase III randomized controlled multicenter GRETA trial.
Mustacchi G, Ceccherini R, Milani S, Pluchinotta A, De Matteis A, Maiorino L, Farris A, Scanni A, Sasso F, Italian Cooperative Group GRETA.
Oncology Center, University of Trieste, Napoli, Italy. mustacchi@fmc.univ.trieste.it
BACKGROUND: To Evaluate the efficacy of tamoxifen as primary treatment in women aged over 70 years with operable breast cancer versus surgery followed by adjuvant tamoxifen.
PATIENT AND METHODS: Patients randomly received tamoxifen alone (160 mg a day, then 20 mg / day) for 5 years or surgery followed by tamoxifen (20 mg / day) for 5 years. Overall survival was the main study end point, secondary objectives included breast cancer survival and local control of the disease.
RESULTS: Between 1987 and 1992, 239 patients were Assigned to surgery plus tamoxifen to tamoxifen alone and 235. Comparable treatment arms were for tumor size, clinical nodal status and performance status. At a median follow up 80 months or 274 patient had died. No Difference Between groups had emerged in overall and breast cancer survival. There were 27 local progression in the surgery plus tamoxifen group and 106 in the tamoxifen-alone group (P = 0.0001). In the surgery plus tamoxifen group, no difference in overall survival had emerged According To the extension of operation.
CONCLUSIONS: The long-term results of the study confirm the 3-year interim analysis Already reported. Surgery (radical or minimal) followed by adjuvant tamoxifen does not modify overall and breast cancer survival as compared with tamoxifen alone in early breast cancer and older women. Because of the high rate of local progression with tamoxifen alone, minimal surgery followed by tamoxifen Appears to be the Appropriate treatment of Such Patients. More extensification surgery is not useful. Tamoxifen alone is an adequate alternative treatment in very old or Frail Patients.
