Tamoxifen or surgery plus tamoxifen as primary treatment for elderly patients with operable breast cancer: The G.R.E.T.A. Trial. Group for Research on Endocrine Therapy in the Elderly.
A multicentre trial in operable breast cancer in patients aged over 70 years compared tamoxifen alone (starting with a loading dose of 160 mg on the first day) with surgery plus adjuvant tamoxifen. 473 patients were recruited with a median follow up of 36 months. Local progression occurred in 15/237 patients in the surgical arm versus 60/236 in the tamoxifen alone arm (p = 0.000). There were 48 deaths in the surgical arm and 41 in the other one (p = 0.67). Distant metastases occurred in 33/237 patients in the surgical arm versus 19/236 in the tamoxifen alone arm (p = 0.058). In elderly patients with operable breast cancer surgery is indicated. Tamoxifen alone is an adequate alternative in frail patients. A loading dose of Tamoxifen may be useful in preventing the expression of the metastatizing phenotype. In any case, delayed surgery does not prejudice the overall survival.
Mustacchi
G
G
Centro Oncologico, Università di Trieste, Italy.
Milani
S
S
Pluchinotta
A
A
De Matteis
A
A
Rubagotti
A
A
Perrota
A
A
D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000601:surgery*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D011446:Prospective Studies; D015996:Survival Rate; D013629:Tamoxifen / Q000627:therapeutic use*
D013629:Tamoxifen