Tamoxifen in breast conservation therapy.
Breast conservation surgery for early breast cancer requires post-operative radiotherapy to give local control rates equivalent to mastectomy. Three hundred and thirty-five women presenting with symptomatic breast lumps and receiving radiotherapy and adjuvant systemic therapy at St. Bartholomew's, have actuarial 8-year local relapse-free rates of 90% for T1 and 83% for T2,3 presenting cases. Amongst 49 elderly and/or medically frail patients treated with a similar surgical policy but post-operative tamoxifen only (for standard risk features), the local relapse-free rates were 96% for T1 and 43% for T2,3. Most relapses occurred in the first 2 years in both groups. We conclude that, in the absence of high risk features (defined), breast conservation surgery and tamoxifen only is a safe option for T1 disease in the elderly, but that the risk of local relapse is considerably higher when this policy is employed for patients presenting with larger tumors.
Lee
K S
KS
Breast Unit, St. Bartholomew's Hospital, London, UK.
Plowman
P N
PN
Gilmore
O J
OJ
Gray
R
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy / Q000601:surgery; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000517:prevention & control*; D018570:Risk Assessment; D013629:Tamoxifen / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*
D013629:Tamoxifen