Lumpectomy plus tamoxifen with or without irradiation in women age 70 years or older with early breast cancer: Long-term follow-up of CALGB 9343 Journal Article
| Authors: | Hughes, K. S.; Schnaper, L. A.; Bellon, J. R.; Cirrincione, C. T.; Berry, D. A.; McCormick, B.; Muss, H. B.; Smith, B. L.; Hudis, C. A.; Winer, E. P.; Wood, W. C. |
| Article Title: | Lumpectomy plus tamoxifen with or without irradiation in women age 70 years or older with early breast cancer: Long-term follow-up of CALGB 9343 |
| Abstract: | Purpose To determine whether there is a benefit to adjuvant radiation therapy after breast-conserving surgery and tamoxifen in women age 70 years with early-stage breast cancer. Patients and Methods Between July 1994 and February 1999, 636 women (age 70 years) who had clinical stage I (T1N0M0 according to TNM classification) estrogen receptor (ER) -positive breast carcinoma treated by lumpectomy were randomly assigned to receive tamoxifen plus radiation therapy (TamRT; 317 women) or tamoxifen alone (Tam; 319 women). Primary end points were time to local or regional recurrence, frequency of mastectomy, breast cancer-specific survival, time to distant metastasis, and overall survival (OS). Results Median follow-up for treated patients is now 12.6 years. At 10 years, 98% of patients receiving TamRT (95% CI, 96% to 99%) compared with 90% of those receiving Tam (95% CI, 85% to 93%) were free from local and regional recurrences. There were no significant differences in time to mastectomy, time to distant metastasis, breast cancer-specific survival, or OS between the two groups. Ten-year OS was 67% (95% CI, 62% to 72%) and 66% (95% CI, 61% to 71%) in the TamRT and Tam groups, respectively. Conclusion With long-term follow-up, the previously observed small improvement in locoregional recurrence with the addition of radiation therapy remains. However, this does not translate into an advantage in OS, distant disease-free survival, or breast preservation. Depending on the value placed on local recurrence, Tam remains a reasonable option for women age 70 years with ER-positive early-stage breast cancer. |
| Keywords: | radiotherapy; recurrence; therapy; metaanalysis; conserving surgery; randomized clinical-trial |
| Journal Title: | Journal of Clinical Oncology |
| Volume: | 31 |
| Issue: | 19 |
| ISSN: | 0732-183X |
| Publisher: | American Society of Clinical Oncology |
| Date Published: | 2013-07-01 |
| Start Page: | 2382 |
| End Page: | 2387 |
| Language: | English |
| ACCESSION: | WOS:000330520600017 |
| DOI: | 10.1200/jco.2012.45.2615 |
| PROVIDER: | wos |
| PMCID: | PMC3691356 |
| PUBMED: | 23690420 |
| Notes: | Article -- Source: Wos |
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