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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  1. Clifford Hudis
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  2. Beryl McCormick
    372 McCormick