The Scottish trial of adjuvant tamoxifen in node-negative breast cancer. Scottish Cancer Trials Breast Group.
This paper presents results, 5 years after closure, of a randomized trial comparing adjuvant with postrelapse tamoxifen in 747 women with histological node-negative breast cancer. Two hundred thirty-six disease-free patients on adjuvant therapy were secondarily randomly assigned at 5 years to stop or to continue tamoxifen until relapse. Adjuvant tamoxifen, taken for a median duration of 60 months, has significantly prolonged disease-free survival overall (P = .0001), in the 214 premenopausal group (P = .018), in the 533 postmenopausal group (P = .0026), and for the 246 patients with estrogen receptor levels greater than 19 fmol/mg of protein (P = .0032); distant relapse has also been delayed overall (P = .029). Total survival comparison by Kaplan-Meier life-table analysis shows a nonsignificant trend in the same direction (P = .07). Adjuvant tamoxifen has also reduced the incidence of contralateral breast cancer and of death from myocardial infarction. No increase in the incidence of endometrial cancer has been found.
Stewart
H J
HJ
The Medical School, University of Edinburgh, Scotland, UK.
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000737:chemistry / Q000188:drug therapy* / Q000401:mortality; D002278:Carcinoma in Situ / Q000453:epidemiology; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000453:epidemiology; D002423:Cause of Death; D017024:Chemotherapy, Adjuvant; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015993:Life Tables; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D016609:Neoplasms, Second Primary / Q000453:epidemiology; D011960:Receptors, Estrogen / Q000032:analysis; D012307:Risk Factors; D012606:Scotland; D015996:Survival Rate; D013629:Tamoxifen / Q000008:administration & dosage*
D011960:Receptors, Estrogen; D013629:Tamoxifen