Lumpectomy plus tamoxifen with or without irradiation in women 70 years of age or older with early breast cancer.

By L. Schnaper, D. Berry, C. Cirrincione, Thomas J Smith, Barbara L. Smith, C. Shapiro. New England Journal of Medicine, 2004

1,025 citations recorded by the source corpus.

BACKGROUND In women 70 years of age or older who have early breast cancer, it is unclear whether lumpectomy plus tamoxifen is as effective as lumpectomy followed by tamoxifen plus radiation therapy. METHODS Between July 1994 and February 1999, we randomly assigned 636 women who were 70 years of age or older and who had clinical stage I (T1N0M0 according to the tumor-node-metastasis classification), estrogen-receptor-positive breast carcinoma treated by lumpectomy to receive tamoxifen plus radiation therapy (317 women) or tamoxifen alone (319 women). Primary end points were the time to local or regional recurrence, the frequency of mastectomy for recurrence, breast-cancer-specific survival, the time to distant metastasis, and overall survival. RESULTS The only significant difference between the two groups was in the rate of local or regional recurrence at five years (1 percent in the group given tamoxifen plus irradiation and 4 percent in the group given tamoxifen alone, P<0.001). There were no significant differences between the two groups with regard to the rates of mastectomy for local recurrence, distant metastases, or five-year rates of overall survival (87 percent in the group given tamoxifen plus irradiation and 86 percent in the tamoxifen group, P=0.94). Assessment by physicians and patients of cosmetic results and adverse events uniformly rated tamoxifen plus irradiation inferior to tamoxifen alone. CONCLUSIONS Lumpectomy plus adjuvant therapy with tamoxifen alone is a realistic choice for the treatment of women 70 years of age or older who have early, estrogen-receptor-positive breast cancer.

Subfields: Cancer Research, Pathology and Forensic Medicine, Public Health, Environmental and Occupational Health

View Paper: https://www.semanticscholar.org/paper/485a7ef3c4dfe226fabe009293c9c3f5c655adbf

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Citations in the corpus

• 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. (2013, methodology): “RT included tangential fields to the entire breast followed by an electron boost to the lumpectomy site.(6) Tamoxifen.”
• Advances in Radiation Therapy: Conventional to 3D, to IMRT, to 4D, and Beyond (2005, background): “The only study where the authors concluded that it may be reasonable to omit breast irradiation and treat with tamoxifen alone randomized 636 women who were 70 years or older with estrogen receptor-positive, early-stage breast cancer (node negative and 2 cm) to breast irradiation plus tamoxifen or t”
• Meeting highlights: international expert consensus on the primary therapy of early breast cancer 2005. (2005, background): “It remains uncertain whether radiation therapy may be omitted for women above the age of 70 years with clear margins who also receive adjuvant endocrine therapy [52].”
• Primary breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. (2015, background): “In patients >70 years of age who have endocrine-responsive invasive breast cancer with maximum stage pT1N0 and clear margins, it may be possible to omit radiation therapy without compromising survival [II, B] [36, 48].”