title: Patterns of recurrence of early breast cancer according to estrogen receptor status: a therapeutic target for a quarter of a century.
abstract: The current therapeutic strategy in breast cancer is to identify a target, such as estrogen receptor (ER) status, for tailoring treatments. We investigated the patterns of recurrence with respect to ER status for patients treated in two randomized trials with 25 years' median follow-up. In the ER-negative subpopulations most breast cancer events occurred within the first 5-7 years after randomization, while in the ER-positive subpopulations breast cancer events were spread through 10 years. In the ER-positive subpopulation, 1 year endocrine treatment alone significantly prolonged disease-free survival (DFS) with no additional benefit observed by adding 1 year of chemotherapy. In the small ER-negative subpopulation chemo-endocrine therapy had a significantly better DFS than endocrine alone or no treatment. Despite small numbers of patients, "old-fashioned" treatments, and competing causes of treatment failure, the value of ER status as a target for response to adjuvant treatment is evident through prolonged follow-up.
authors.affiliation: Oncology Institute of Southern Switzerland, Ospedale Italiano, Viganello, Lugano, Switzerland. olivia.pagani@ibcsg.org
authors.forename: Olivia
authors.initials: O
authors.lastname: Pagani
authors.forename: Karen N
authors.initials: KN
authors.lastname: Price
authors.forename: Richard D
authors.initials: RD
authors.lastname: Gelber
authors.forename: Monica
authors.initials: M
authors.lastname: Castiglione-Gertsch
authors.forename: Stig B
authors.initials: SB
authors.lastname: Holmberg
authors.forename: Jurij
authors.initials: J
authors.lastname: Lindtner
authors.forename: Beat
authors.initials: B
authors.lastname: Thürlimann
authors.forename: John
authors.initials: J
authors.lastname: Collins
authors.forename: Martin F
authors.initials: MF
authors.lastname: Fey
authors.forename: Alan S
authors.initials: AS
authors.lastname: Coates
authors.forename: Aron
authors.initials: A
authors.lastname: Goldhirsch
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000378:metabolism* / Q000473:pathology; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000378:metabolism* / Q000473:pathology; D016032:Randomized Controlled Trials as Topic; D011960:Receptors, Estrogen / Q000096:biosynthesis*; D016896:Treatment Outcome
chemical_list: D018931:Antineoplastic Agents, Hormonal; D011960:Receptors, Estrogen