title: Oophorectomy and tamoxifen adjuvant therapy in premenopausal Vietnamese and Chinese women with operable breast cancer.
abstract: OBJECTIVE
  In 1992, the Early Breast Cancer Trialists' Collaborative Group reported that a meta-analysis of six randomized trials in European and North American women begun from 1948 to 1972 demonstrated disease-free and overall survival benefit from adjuvant ovarian ablation. Approximately 350,000 new cases of breast cancer are diagnosed annually in premenopausal Asian women who have lower levels of estrogen than western women.
  
  
  METHODS
  From 1993 to 1999, we recruited 709 premenopausal women with operable breast cancer (652 from Vietnam, 47 from China) to a randomized clinical trial of adjuvant oophorectomy and tamoxifen (20 mg orally every day) for 5 years or observation and this combined hormonal treatment on recurrence. At later dates estrogen- and progesterone-receptor protein assays by immunohistochemistry were performed for 470 of the cases (66%).
  
  
  RESULTS
  Treatment arms were well balanced. With a median follow-up of 3.6 years, there have been 84 events and 69 deaths in the adjuvant treatment group and 127 events and 91 deaths in the observation group, with 5-year disease-free survival rates of 75% and 58% (P =.0003 unadjusted; P =.0075 adjusted), and overall survival rates of 78% and 70% (P =.041 unadjusted) for the adjuvant and observation groups, respectively. Only patients with hormone receptor-positive tumors benefited from the adjuvant treatment. In Vietnam, for women unselected for hormone receptor status, a cost-effectiveness analysis suggests that this intervention costs $350 per year of life saved.
  
  
  CONCLUSIONS
  Vietnamese and Chinese women with hormone receptor-positive operable breast cancer benefit from adjuvant treatment with surgical oophorectomy and tamoxifen.
authors: University of Wisconsin Comprehensive Cancer Center, 610 Walnut Street, Madison, WI 53705-2397, USA. rrlove@facstaff.wisc.edu
authors: Richard R
authors: RR
authors: Love
authors: Nguyen Ba
authors: NB
authors: Duc
authors: D Craig
authors: DC
authors: Allred
authors: Nguyen Cong
authors: NC
authors: Binh
authors: Nguyen Van
authors: NV
authors: Dinh
authors: Nguyen Ngoc
authors: NN
authors: Kha
authors: Tran Van
authors: TV
authors: Thuan
authors: Syed K
authors: SK
authors: Mohsin
authors: Le Dinh
authors: le D
authors: Roanh
authors: Hoang Xuan
authors: HX
authors: Khang
authors: Trinh Luong
authors: TL
authors: Tran
authors: Tran Tu
authors: TT
authors: Quy
authors: Nguyen Van
authors: NV
authors: Thuy
authors: Pham Nhu
authors: PN
authors: Thé
authors: Ton That
authors: TT
authors: Cau
authors: Nguyen Dinh
authors: ND
authors: Tung
authors: Dang Thanh
authors: DT
authors: Huong
authors: Le Minh
authors: le M
authors: Quang
authors: Nguyen Ngoc
authors: NN
authors: Hien
authors: Le
authors: L
authors: Thuong
authors: Tian-Zhen
authors: TZ
authors: Shen
authors: Ye
authors: Y
authors: Xin
authors: Qian
authors: Q
authors: Zhang
authors: Thomas C
authors: TC
authors: Havighurst
authors: Yonghong Fred
authors: YF
authors: Yang
authors: Bruce E
authors: BE
authors: Hillner
authors: David L
authors: DL
authors: DeMets
mesh_terms: D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D001365:Axilla; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000208:ethnology / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D002681:China / Q000453:epidemiology; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D009367:Neoplasm Staging; D010052:Ovariectomy; D017697:Premenopause; D011379:Prognosis; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D013629:Tamoxifen / Q000627:therapeutic use*; D016896:Treatment Outcome; D014744:Vietnam / Q000453:epidemiology
chemical_list: D018931:Antineoplastic Agents, Hormonal; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D013629:Tamoxifen