title: Treatment of operable breast cancer in the elderly: a randomised clinical trial EORTC 10851 comparing tamoxifen alone with modified radical mastectomy.
abstract: For treatment of early breast cancer in older women, little evidence is available from randomised trials. We conducted a randomised trial comparing modified radical mastectomy (MRM) with tamoxifen (TAM) as the sole initial therapy in 164 patients aged >/=70 years with operable breast cancer. 82 were treated by MRM and 82 with TAM. Survival curves were estimated using the Kaplan-Meier method: multivariate analyses were performed using the Cox's proportional hazards model. Endpoints included survival, time to first relapse or progression, loco-regional progression, time to distant progression and progression-free survival. After a median follow-up of approximately 10 years, there was a significantly decreased time to progression in the TAM only group (logrank P<0.0001) and significantly shorter time to local progression within the TAM group (logrank P<0.0001). Overall survival of the two groups was similar. The results indicate that tamoxifen alone leads to an unacceptably high rate of local progression or relapse.
authors.affiliation: Hedley Atkins Breast Unit, Guy's Hospital, SE1 9RT, London, UK. ian.fentiman@cancer.org.uk
authors.forename: I S
authors.initials: IS
authors.lastname: Fentiman
authors.forename: M-R
authors.initials: MR
authors.lastname: Christiaens
authors.forename: R
authors.initials: R
authors.lastname: Paridaens
authors.forename: A
authors.initials: A
authors.lastname: Van Geel
authors.forename: E
authors.initials: E
authors.lastname: Rutgers
authors.forename: J
authors.initials: J
authors.lastname: Berner
authors.forename: G
authors.initials: G
authors.lastname: de Keizer
authors.forename: J
authors.initials: J
authors.lastname: Wildiers
authors.forename: M
authors.initials: M
authors.lastname: Nagadowska
authors.forename: C
authors.initials: C
authors.lastname: Legrand
authors.forename: P
authors.initials: P
authors.lastname: Therasse
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000601:surgery*; D003131:Combined Modality Therapy / Q000379:methods; D018450:Disease Progression; D005260:Female; D006801:Humans; D015409:Mastectomy, Radical; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000209:etiology; D011446:Prospective Studies; D016879:Salvage Therapy; D016019:Survival Analysis; D013629:Tamoxifen / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D018931:Antineoplastic Agents, Hormonal; D013629:Tamoxifen