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.
Centro Oncologico, Università di Trieste, Italy.
G
G
Mustacchi
S
S
Milani
A
A
Pluchinotta
A
A
De Matteis
A
A
Rubagotti
A
A
Perrota
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