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  • Relevance of breast cancer hormone receptors and other factors to the efficacyof adjuvant tamoxifen : patient-level meta-analysis of randomised trials
    Background: As trials of 5 years of tamoxifen in early breast cancer mature, the relevance of hormone receptor measurements (and other patient characteristics) to long-term outcome can be assessed ... increasingly reliably. We report updated meta-analyses of the trials of 5 years of adjuvant tamoxifen. Methods: We undertook a collaborative meta-analysis of individual patient data from 20 trials (n=21,457) in early breast cancer of about 5 yearsof tamoxifen versus no adjuvant tamoxifen, with about 80% compliance. Recurrence and death rate ratios (RRs) were from log-rank analyses by allocated treatment. Findings: In oestrogen receptor (ER)-positive disease (n=10,645), allocation to about 5 years of tamoxifen substantially reduced recurrence rates throughout the first 10 years (RR 0 53 šSE 0 03đ during years0-4 and RR 0 68 š0 06đ during years 5-9 šboth 2p<0 00001đ; but RR 0 97 š010đ during years 10-14, suggesting no further gain or loss after year 10). Even in marginally ER-positive disease (10-19 fmol/mg cytosol protein) the recurrence reduction was substantial (RR 0 67 š0 08đ). In ER-positive disease,the RR was approximately independent of progesterone receptor status (or level), age, nodal status, or use of chemotherapy. Breast cancer mortalitywas reduced by about a third throughout the first 15 years (RR 0 71 š0 05đ during years 0-4, 0 66 š0 05đ during years 5-9, and 0 68 š0 08đ during years 10-14; p<0 0001 for extra mortality reduction during each separate time period). Overall non-breast-cancer mortality was little affected, despite small absolute increases in thromboembolic and uterine cancer mortality (both only in women older than 55 years), so all-cause mortality was substantially reduced. In ER-negative disease, tamoxifen had little or no effect on breast cancer recurrence or mortality. Interpretation: 5 years of adjuvant tamoxifen safely reduces 15-year risks of breast cancer recurrence and death. (Abstract truncated at 2000 character)
    Source: The Lancet. - ISSN 0140-6736 (Vol. 378, iss. 9793, 2011, str. 771-784)
    Type of material - article, component part
    Publish date - 2011
    Language - english
    COBISS.SI-ID - 29393881
    DOI

source: The Lancet. - ISSN 0140-6736 (Vol. 378, iss. 9793, 2011, str. 771-784)
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