title: Clinical criteria as predictive factors of response to primary hormone therapy in locally advanced breast cancer.
abstract: This study investigates the efficacy of clinical criteria in selecting patients for primary tamoxifen therapy. A total of 60 breast cancer patients with large primary tumors and unknown hormonal receptor status were subjected to primary hormone therapy. Inclusion criteria were age over 60 years old or menopausal status for at least 10 years and no clinical evidence of inflammatory disease and fast tumor growth. The objective response rate was 55%. There was a positive correlation between the lack of clinical response and axillary lymph node metastasis (p = 0.009). Patients with objective response had significantly improved disease-free (p = 0.045) and overall (p = 0.0002) survival over those who did not have response to hormonal therapy. In multivariate analysis, the clinical response to therapy was the most powerful prognostic factor. This analysis demonstrates that clinical criteria were very effective predictor of response to neo-adjuvant hormone therapy in large breast tumors for postmenopausal women. Response to therapy is the major prognostic factor in primary tamoxifen-treated breast cancer.
authors.affiliation: Department of Gynecology and Obstetrics, Breast Disease Division, Hospital das Clínicas of Ribeirão Preto School of Medicine, University of São Paulo, São Paulo, Brazil.
authors.forename: Daniel Guimarães
authors.initials: DG
authors.lastname: Tiezzi
authors.forename: Jurandyr Moreira
authors.initials: JM
authors.lastname: de Andrade
authors.forename: Heitor Ricardo Cosiski
authors.initials: HR
authors.lastname: Marana
authors.forename: Alexandre Pavan
authors.initials: AP
authors.lastname: Garieri
authors.forename: Paulo Meyer
authors.initials: PM
authors.lastname: de Paula Philbert
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D017698:Postmenopause; D013629:Tamoxifen / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D018931:Antineoplastic Agents, Hormonal; D013629:Tamoxifen