title: Cholesterol, Cholesterol-Lowering Medication Use, and Breast Cancer Outcome in the BIG 1-98 Study.
abstract: Purpose Cholesterol-lowering medication (CLM) has been reported to have a role in preventing breast cancer recurrence. CLM may attenuate signaling through the estrogen receptor by reducing levels of the estrogenic cholesterol metabolite 27-hydroxycholesterol. The impact of endocrine treatment on cholesterol levels and hypercholesterolemia per se may counteract the intended effect of aromatase inhibitors. Patients and Methods The Breast International Group (BIG) conducted a randomized, phase III, double-blind trial, BIG 1-98, which enrolled 8,010 postmenopausal women with early-stage, hormone receptor-positive invasive breast cancer from 1998 to 2003. Systemic levels of total cholesterol and use of CLM were measured at study entry and every 6 months up to 5.5 years. Cumulative incidence functions were used to describe the initiation of CLM in the presence of competing risks. Marginal structural Cox proportional hazards modeling investigated the relationships between initiation of CLM during endocrine therapy and outcome. Three time-to-event end points were considered: disease-free-survival, breast cancer-free interval, and distant recurrence-free interval. Results Cholesterol levels were reduced during tamoxifen therapy. Of 789 patients who initiated CLM during endocrine therapy, the majority came from the letrozole monotherapy arm (n = 318), followed by sequential tamoxifen-letrozole (n = 189), letrozole-tamoxifen (n = 176), and tamoxifen monotherapy (n = 106). Initiation of CLM during endocrine therapy was related to improved disease-free-survival (hazard ratio [HR], 0.79; 95% CI, 0.66 to 0.95; P = .01), breast cancer-free interval (HR, 0.76; 95% CI, 0.60 to 0.97; P = .02), and distant recurrence-free interval (HR, 0.74; 95% CI, 0.56 to 0.97; P = .03). Conclusion Cholesterol-lowering medication during adjuvant endocrine therapy may have a role in preventing breast cancer recurrence in hormone receptor-positive early-stage breast cancer. We recommend that these observational results be addressed in prospective randomized trials.
authors.affiliation: Signe Borgquist and Judy E. Garber, Dana-Farber Cancer Institute, Harvard Medical School; Anita Giobbie-Hurder, International Breast Cancer Study Group (IBCSG) Statistical Center, Dana-Farber Cancer Institute; Richard D. Gelber, IBCSG Statistical Center, Dana-Farber Cancer Institute, Harvard Medical School, T.H. Chan Harvard School of Public Health, and Frontier Science and Technology Research Foundation; Karen N. Price, IBCSG Statistical Center and Frontier Science and Technology Research Foundation; Meredith M. Regan, IBCSG Statistical Center, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, MA; Signe Borgquist, Lund University, Lund, Sweden; Thomas P. Ahern, University of Vermont, Burlington, VT; Marco Colleoni and Aron Goldhirsch, IBCSG and European Institute of Oncology, Milan, Italy; István Láng, IBCSG and National Institute of Oncology, Budapest, Hungary; Marc Debled, Institut Bergonié, Bordeaux, France; Bent Ejlertsen, Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen, Denmark; Roger von Moos, Cantonal Hospital Graubuenden, Chur; Swiss Group for Clinical Cancer Research and IBCSG; Manuela Rabaglio, IBCSG Coordinating Center and Inselspital, Bern; Beat Thürlimann, Breast Center St. Gallen, Kantonsspital, St. Gallen; Swiss Group for Clinical Cancer Research and IBCSG, Bern, Switzerland; Ian Smith, The Royal Marsden Hospital, London, United Kingdom; and Alan S. Coates, IBCSG and University of Sydney School of Public Health, Sydney, Australia.
authors.forename: Signe
authors.initials: S
authors.lastname: Borgquist
authors.affiliation: Signe Borgquist and Judy E. Garber, Dana-Farber Cancer Institute, Harvard Medical School; Anita Giobbie-Hurder, International Breast Cancer Study Group (IBCSG) Statistical Center, Dana-Farber Cancer Institute; Richard D. Gelber, IBCSG Statistical Center, Dana-Farber Cancer Institute, Harvard Medical School, T.H. Chan Harvard School of Public Health, and Frontier Science and Technology Research Foundation; Karen N. Price, IBCSG Statistical Center and Frontier Science and Technology Research Foundation; Meredith M. Regan, IBCSG Statistical Center, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, MA; Signe Borgquist, Lund University, Lund, Sweden; Thomas P. Ahern, University of Vermont, Burlington, VT; Marco Colleoni and Aron Goldhirsch, IBCSG and European Institute of Oncology, Milan, Italy; István Láng, IBCSG and National Institute of Oncology, Budapest, Hungary; Marc Debled, Institut Bergonié, Bordeaux, France; Bent Ejlertsen, Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen, Denmark; Roger von Moos, Cantonal Hospital Graubuenden, Chur; Swiss Group for Clinical Cancer Research and IBCSG; Manuela Rabaglio, IBCSG Coordinating Center and Inselspital, Bern; Beat Thürlimann, Breast Center St. Gallen, Kantonsspital, St. Gallen; Swiss Group for Clinical Cancer Research and IBCSG, Bern, Switzerland; Ian Smith, The Royal Marsden Hospital, London, United Kingdom; and Alan S. Coates, IBCSG and University of Sydney School of Public Health, Sydney, Australia.
authors.forename: Anita
authors.initials: A
authors.lastname: Giobbie-Hurder
authors.affiliation: Signe Borgquist and Judy E. Garber, Dana-Farber Cancer Institute, Harvard Medical School; Anita Giobbie-Hurder, International Breast Cancer Study Group (IBCSG) Statistical Center, Dana-Farber Cancer Institute; Richard D. Gelber, IBCSG Statistical Center, Dana-Farber Cancer Institute, Harvard Medical School, T.H. Chan Harvard School of Public Health, and Frontier Science and Technology Research Foundation; Karen N. Price, IBCSG Statistical Center and Frontier Science and Technology Research Foundation; Meredith M. Regan, IBCSG Statistical Center, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, MA; Signe Borgquist, Lund University, Lund, Sweden; Thomas P. Ahern, University of Vermont, Burlington, VT; Marco Colleoni and Aron Goldhirsch, IBCSG and European Institute of Oncology, Milan, Italy; István Láng, IBCSG and National Institute of Oncology, Budapest, Hungary; Marc Debled, Institut Bergonié, Bordeaux, France; Bent Ejlertsen, Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen, Denmark; Roger von Moos, Cantonal Hospital Graubuenden, Chur; Swiss Group for Clinical Cancer Research and IBCSG; Manuela Rabaglio, IBCSG Coordinating Center and Inselspital, Bern; Beat Thürlimann, Breast Center St. Gallen, Kantonsspital, St. Gallen; Swiss Group for Clinical Cancer Research and IBCSG, Bern, Switzerland; Ian Smith, The Royal Marsden Hospital, London, United Kingdom; and Alan S. Coates, IBCSG and University of Sydney School of Public Health, Sydney, Australia.
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Ahern
authors.affiliation: Signe Borgquist and Judy E. Garber, Dana-Farber Cancer Institute, Harvard Medical School; Anita Giobbie-Hurder, International Breast Cancer Study Group (IBCSG) Statistical Center, Dana-Farber Cancer Institute; Richard D. Gelber, IBCSG Statistical Center, Dana-Farber Cancer Institute, Harvard Medical School, T.H. Chan Harvard School of Public Health, and Frontier Science and Technology Research Foundation; Karen N. Price, IBCSG Statistical Center and Frontier Science and Technology Research Foundation; Meredith M. Regan, IBCSG Statistical Center, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, MA; Signe Borgquist, Lund University, Lund, Sweden; Thomas P. Ahern, University of Vermont, Burlington, VT; Marco Colleoni and Aron Goldhirsch, IBCSG and European Institute of Oncology, Milan, Italy; István Láng, IBCSG and National Institute of Oncology, Budapest, Hungary; Marc Debled, Institut Bergonié, Bordeaux, France; Bent Ejlertsen, Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen, Denmark; Roger von Moos, Cantonal Hospital Graubuenden, Chur; Swiss Group for Clinical Cancer Research and IBCSG; Manuela Rabaglio, IBCSG Coordinating Center and Inselspital, Bern; Beat Thürlimann, Breast Center St. Gallen, Kantonsspital, St. Gallen; Swiss Group for Clinical Cancer Research and IBCSG, Bern, Switzerland; Ian Smith, The Royal Marsden Hospital, London, United Kingdom; and Alan S. Coates, IBCSG and University of Sydney School of Public Health, Sydney, Australia.
authors.forename: Judy E
authors.initials: JE
authors.lastname: Garber
authors.affiliation: Signe Borgquist and Judy E. Garber, Dana-Farber Cancer Institute, Harvard Medical School; Anita Giobbie-Hurder, International Breast Cancer Study Group (IBCSG) Statistical Center, Dana-Farber Cancer Institute; Richard D. Gelber, IBCSG Statistical Center, Dana-Farber Cancer Institute, Harvard Medical School, T.H. Chan Harvard School of Public Health, and Frontier Science and Technology Research Foundation; Karen N. Price, IBCSG Statistical Center and Frontier Science and Technology Research Foundation; Meredith M. Regan, IBCSG Statistical Center, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, MA; Signe Borgquist, Lund University, Lund, Sweden; Thomas P. Ahern, University of Vermont, Burlington, VT; Marco Colleoni and Aron Goldhirsch, IBCSG and European Institute of Oncology, Milan, Italy; István Láng, IBCSG and National Institute of Oncology, Budapest, Hungary; Marc Debled, Institut Bergonié, Bordeaux, France; Bent Ejlertsen, Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen, Denmark; Roger von Moos, Cantonal Hospital Graubuenden, Chur; Swiss Group for Clinical Cancer Research and IBCSG; Manuela Rabaglio, IBCSG Coordinating Center and Inselspital, Bern; Beat Thürlimann, Breast Center St. Gallen, Kantonsspital, St. Gallen; Swiss Group for Clinical Cancer Research and IBCSG, Bern, Switzerland; Ian Smith, The Royal Marsden Hospital, London, United Kingdom; and Alan S. Coates, IBCSG and University of Sydney School of Public Health, Sydney, Australia.
authors.forename: Marco
authors.initials: M
authors.lastname: Colleoni
authors.affiliation: Signe Borgquist and Judy E. Garber, Dana-Farber Cancer Institute, Harvard Medical School; Anita Giobbie-Hurder, International Breast Cancer Study Group (IBCSG) Statistical Center, Dana-Farber Cancer Institute; Richard D. Gelber, IBCSG Statistical Center, Dana-Farber Cancer Institute, Harvard Medical School, T.H. Chan Harvard School of Public Health, and Frontier Science and Technology Research Foundation; Karen N. Price, IBCSG Statistical Center and Frontier Science and Technology Research Foundation; Meredith M. Regan, IBCSG Statistical Center, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, MA; Signe Borgquist, Lund University, Lund, Sweden; Thomas P. Ahern, University of Vermont, Burlington, VT; Marco Colleoni and Aron Goldhirsch, IBCSG and European Institute of Oncology, Milan, Italy; István Láng, IBCSG and National Institute of Oncology, Budapest, Hungary; Marc Debled, Institut Bergonié, Bordeaux, France; Bent Ejlertsen, Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen, Denmark; Roger von Moos, Cantonal Hospital Graubuenden, Chur; Swiss Group for Clinical Cancer Research and IBCSG; Manuela Rabaglio, IBCSG Coordinating Center and Inselspital, Bern; Beat Thürlimann, Breast Center St. Gallen, Kantonsspital, St. Gallen; Swiss Group for Clinical Cancer Research and IBCSG, Bern, Switzerland; Ian Smith, The Royal Marsden Hospital, London, United Kingdom; and Alan S. Coates, IBCSG and University of Sydney School of Public Health, Sydney, Australia.
authors.forename: István
authors.initials: I
authors.lastname: Láng
authors.affiliation: Signe Borgquist and Judy E. Garber, Dana-Farber Cancer Institute, Harvard Medical School; Anita Giobbie-Hurder, International Breast Cancer Study Group (IBCSG) Statistical Center, Dana-Farber Cancer Institute; Richard D. Gelber, IBCSG Statistical Center, Dana-Farber Cancer Institute, Harvard Medical School, T.H. Chan Harvard School of Public Health, and Frontier Science and Technology Research Foundation; Karen N. Price, IBCSG Statistical Center and Frontier Science and Technology Research Foundation; Meredith M. Regan, IBCSG Statistical Center, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, MA; Signe Borgquist, Lund University, Lund, Sweden; Thomas P. Ahern, University of Vermont, Burlington, VT; Marco Colleoni and Aron Goldhirsch, IBCSG and European Institute of Oncology, Milan, Italy; István Láng, IBCSG and National Institute of Oncology, Budapest, Hungary; Marc Debled, Institut Bergonié, Bordeaux, France; Bent Ejlertsen, Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen, Denmark; Roger von Moos, Cantonal Hospital Graubuenden, Chur; Swiss Group for Clinical Cancer Research and IBCSG; Manuela Rabaglio, IBCSG Coordinating Center and Inselspital, Bern; Beat Thürlimann, Breast Center St. Gallen, Kantonsspital, St. Gallen; Swiss Group for Clinical Cancer Research and IBCSG, Bern, Switzerland; Ian Smith, The Royal Marsden Hospital, London, United Kingdom; and Alan S. Coates, IBCSG and University of Sydney School of Public Health, Sydney, Australia.
authors.forename: Marc
authors.initials: M
authors.lastname: Debled
authors.affiliation: Signe Borgquist and Judy E. Garber, Dana-Farber Cancer Institute, Harvard Medical School; Anita Giobbie-Hurder, International Breast Cancer Study Group (IBCSG) Statistical Center, Dana-Farber Cancer Institute; Richard D. Gelber, IBCSG Statistical Center, Dana-Farber Cancer Institute, Harvard Medical School, T.H. Chan Harvard School of Public Health, and Frontier Science and Technology Research Foundation; Karen N. Price, IBCSG Statistical Center and Frontier Science and Technology Research Foundation; Meredith M. Regan, IBCSG Statistical Center, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, MA; Signe Borgquist, Lund University, Lund, Sweden; Thomas P. Ahern, University of Vermont, Burlington, VT; Marco Colleoni and Aron Goldhirsch, IBCSG and European Institute of Oncology, Milan, Italy; István Láng, IBCSG and National Institute of Oncology, Budapest, Hungary; Marc Debled, Institut Bergonié, Bordeaux, France; Bent Ejlertsen, Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen, Denmark; Roger von Moos, Cantonal Hospital Graubuenden, Chur; Swiss Group for Clinical Cancer Research and IBCSG; Manuela Rabaglio, IBCSG Coordinating Center and Inselspital, Bern; Beat Thürlimann, Breast Center St. Gallen, Kantonsspital, St. Gallen; Swiss Group for Clinical Cancer Research and IBCSG, Bern, Switzerland; Ian Smith, The Royal Marsden Hospital, London, United Kingdom; and Alan S. Coates, IBCSG and University of Sydney School of Public Health, Sydney, Australia.
authors.forename: Bent
authors.initials: B
authors.lastname: Ejlertsen
authors.affiliation: Signe Borgquist and Judy E. Garber, Dana-Farber Cancer Institute, Harvard Medical School; Anita Giobbie-Hurder, International Breast Cancer Study Group (IBCSG) Statistical Center, Dana-Farber Cancer Institute; Richard D. Gelber, IBCSG Statistical Center, Dana-Farber Cancer Institute, Harvard Medical School, T.H. Chan Harvard School of Public Health, and Frontier Science and Technology Research Foundation; Karen N. Price, IBCSG Statistical Center and Frontier Science and Technology Research Foundation; Meredith M. Regan, IBCSG Statistical Center, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, MA; Signe Borgquist, Lund University, Lund, Sweden; Thomas P. Ahern, University of Vermont, Burlington, VT; Marco Colleoni and Aron Goldhirsch, IBCSG and European Institute of Oncology, Milan, Italy; István Láng, IBCSG and National Institute of Oncology, Budapest, Hungary; Marc Debled, Institut Bergonié, Bordeaux, France; Bent Ejlertsen, Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen, Denmark; Roger von Moos, Cantonal Hospital Graubuenden, Chur; Swiss Group for Clinical Cancer Research and IBCSG; Manuela Rabaglio, IBCSG Coordinating Center and Inselspital, Bern; Beat Thürlimann, Breast Center St. Gallen, Kantonsspital, St. Gallen; Swiss Group for Clinical Cancer Research and IBCSG, Bern, Switzerland; Ian Smith, The Royal Marsden Hospital, London, United Kingdom; and Alan S. Coates, IBCSG and University of Sydney School of Public Health, Sydney, Australia.
authors.forename: Roger
authors.initials: R
authors.lastname: von Moos
authors.affiliation: Signe Borgquist and Judy E. Garber, Dana-Farber Cancer Institute, Harvard Medical School; Anita Giobbie-Hurder, International Breast Cancer Study Group (IBCSG) Statistical Center, Dana-Farber Cancer Institute; Richard D. Gelber, IBCSG Statistical Center, Dana-Farber Cancer Institute, Harvard Medical School, T.H. Chan Harvard School of Public Health, and Frontier Science and Technology Research Foundation; Karen N. Price, IBCSG Statistical Center and Frontier Science and Technology Research Foundation; Meredith M. Regan, IBCSG Statistical Center, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, MA; Signe Borgquist, Lund University, Lund, Sweden; Thomas P. Ahern, University of Vermont, Burlington, VT; Marco Colleoni and Aron Goldhirsch, IBCSG and European Institute of Oncology, Milan, Italy; István Láng, IBCSG and National Institute of Oncology, Budapest, Hungary; Marc Debled, Institut Bergonié, Bordeaux, France; Bent Ejlertsen, Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen, Denmark; Roger von Moos, Cantonal Hospital Graubuenden, Chur; Swiss Group for Clinical Cancer Research and IBCSG; Manuela Rabaglio, IBCSG Coordinating Center and Inselspital, Bern; Beat Thürlimann, Breast Center St. Gallen, Kantonsspital, St. Gallen; Swiss Group for Clinical Cancer Research and IBCSG, Bern, Switzerland; Ian Smith, The Royal Marsden Hospital, London, United Kingdom; and Alan S. Coates, IBCSG and University of Sydney School of Public Health, Sydney, Australia.
authors.forename: Ian
authors.initials: I
authors.lastname: Smith
authors.affiliation: Signe Borgquist and Judy E. Garber, Dana-Farber Cancer Institute, Harvard Medical School; Anita Giobbie-Hurder, International Breast Cancer Study Group (IBCSG) Statistical Center, Dana-Farber Cancer Institute; Richard D. Gelber, IBCSG Statistical Center, Dana-Farber Cancer Institute, Harvard Medical School, T.H. Chan Harvard School of Public Health, and Frontier Science and Technology Research Foundation; Karen N. Price, IBCSG Statistical Center and Frontier Science and Technology Research Foundation; Meredith M. Regan, IBCSG Statistical Center, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, MA; Signe Borgquist, Lund University, Lund, Sweden; Thomas P. Ahern, University of Vermont, Burlington, VT; Marco Colleoni and Aron Goldhirsch, IBCSG and European Institute of Oncology, Milan, Italy; István Láng, IBCSG and National Institute of Oncology, Budapest, Hungary; Marc Debled, Institut Bergonié, Bordeaux, France; Bent Ejlertsen, Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen, Denmark; Roger von Moos, Cantonal Hospital Graubuenden, Chur; Swiss Group for Clinical Cancer Research and IBCSG; Manuela Rabaglio, IBCSG Coordinating Center and Inselspital, Bern; Beat Thürlimann, Breast Center St. Gallen, Kantonsspital, St. Gallen; Swiss Group for Clinical Cancer Research and IBCSG, Bern, Switzerland; Ian Smith, The Royal Marsden Hospital, London, United Kingdom; and Alan S. Coates, IBCSG and University of Sydney School of Public Health, Sydney, Australia.
authors.forename: Alan S
authors.initials: AS
authors.lastname: Coates
authors.affiliation: Signe Borgquist and Judy E. Garber, Dana-Farber Cancer Institute, Harvard Medical School; Anita Giobbie-Hurder, International Breast Cancer Study Group (IBCSG) Statistical Center, Dana-Farber Cancer Institute; Richard D. Gelber, IBCSG Statistical Center, Dana-Farber Cancer Institute, Harvard Medical School, T.H. Chan Harvard School of Public Health, and Frontier Science and Technology Research Foundation; Karen N. Price, IBCSG Statistical Center and Frontier Science and Technology Research Foundation; Meredith M. Regan, IBCSG Statistical Center, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, MA; Signe Borgquist, Lund University, Lund, Sweden; Thomas P. Ahern, University of Vermont, Burlington, VT; Marco Colleoni and Aron Goldhirsch, IBCSG and European Institute of Oncology, Milan, Italy; István Láng, IBCSG and National Institute of Oncology, Budapest, Hungary; Marc Debled, Institut Bergonié, Bordeaux, France; Bent Ejlertsen, Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen, Denmark; Roger von Moos, Cantonal Hospital Graubuenden, Chur; Swiss Group for Clinical Cancer Research and IBCSG; Manuela Rabaglio, IBCSG Coordinating Center and Inselspital, Bern; Beat Thürlimann, Breast Center St. Gallen, Kantonsspital, St. Gallen; Swiss Group for Clinical Cancer Research and IBCSG, Bern, Switzerland; Ian Smith, The Royal Marsden Hospital, London, United Kingdom; and Alan S. Coates, IBCSG and University of Sydney School of Public Health, Sydney, Australia.
authors.forename: Aron
authors.initials: A
authors.lastname: Goldhirsch
authors.affiliation: Signe Borgquist and Judy E. Garber, Dana-Farber Cancer Institute, Harvard Medical School; Anita Giobbie-Hurder, International Breast Cancer Study Group (IBCSG) Statistical Center, Dana-Farber Cancer Institute; Richard D. Gelber, IBCSG Statistical Center, Dana-Farber Cancer Institute, Harvard Medical School, T.H. Chan Harvard School of Public Health, and Frontier Science and Technology Research Foundation; Karen N. Price, IBCSG Statistical Center and Frontier Science and Technology Research Foundation; Meredith M. Regan, IBCSG Statistical Center, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, MA; Signe Borgquist, Lund University, Lund, Sweden; Thomas P. Ahern, University of Vermont, Burlington, VT; Marco Colleoni and Aron Goldhirsch, IBCSG and European Institute of Oncology, Milan, Italy; István Láng, IBCSG and National Institute of Oncology, Budapest, Hungary; Marc Debled, Institut Bergonié, Bordeaux, France; Bent Ejlertsen, Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen, Denmark; Roger von Moos, Cantonal Hospital Graubuenden, Chur; Swiss Group for Clinical Cancer Research and IBCSG; Manuela Rabaglio, IBCSG Coordinating Center and Inselspital, Bern; Beat Thürlimann, Breast Center St. Gallen, Kantonsspital, St. Gallen; Swiss Group for Clinical Cancer Research and IBCSG, Bern, Switzerland; Ian Smith, The Royal Marsden Hospital, London, United Kingdom; and Alan S. Coates, IBCSG and University of Sydney School of Public Health, Sydney, Australia.
authors.forename: Manuela
authors.initials: M
authors.lastname: Rabaglio
authors.affiliation: Signe Borgquist and Judy E. Garber, Dana-Farber Cancer Institute, Harvard Medical School; Anita Giobbie-Hurder, International Breast Cancer Study Group (IBCSG) Statistical Center, Dana-Farber Cancer Institute; Richard D. Gelber, IBCSG Statistical Center, Dana-Farber Cancer Institute, Harvard Medical School, T.H. Chan Harvard School of Public Health, and Frontier Science and Technology Research Foundation; Karen N. Price, IBCSG Statistical Center and Frontier Science and Technology Research Foundation; Meredith M. Regan, IBCSG Statistical Center, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, MA; Signe Borgquist, Lund University, Lund, Sweden; Thomas P. Ahern, University of Vermont, Burlington, VT; Marco Colleoni and Aron Goldhirsch, IBCSG and European Institute of Oncology, Milan, Italy; István Láng, IBCSG and National Institute of Oncology, Budapest, Hungary; Marc Debled, Institut Bergonié, Bordeaux, France; Bent Ejlertsen, Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen, Denmark; Roger von Moos, Cantonal Hospital Graubuenden, Chur; Swiss Group for Clinical Cancer Research and IBCSG; Manuela Rabaglio, IBCSG Coordinating Center and Inselspital, Bern; Beat Thürlimann, Breast Center St. Gallen, Kantonsspital, St. Gallen; Swiss Group for Clinical Cancer Research and IBCSG, Bern, Switzerland; Ian Smith, The Royal Marsden Hospital, London, United Kingdom; and Alan S. Coates, IBCSG and University of Sydney School of Public Health, Sydney, Australia.
authors.forename: Karen N
authors.initials: KN
authors.lastname: Price
authors.affiliation: Signe Borgquist and Judy E. Garber, Dana-Farber Cancer Institute, Harvard Medical School; Anita Giobbie-Hurder, International Breast Cancer Study Group (IBCSG) Statistical Center, Dana-Farber Cancer Institute; Richard D. Gelber, IBCSG Statistical Center, Dana-Farber Cancer Institute, Harvard Medical School, T.H. Chan Harvard School of Public Health, and Frontier Science and Technology Research Foundation; Karen N. Price, IBCSG Statistical Center and Frontier Science and Technology Research Foundation; Meredith M. Regan, IBCSG Statistical Center, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, MA; Signe Borgquist, Lund University, Lund, Sweden; Thomas P. Ahern, University of Vermont, Burlington, VT; Marco Colleoni and Aron Goldhirsch, IBCSG and European Institute of Oncology, Milan, Italy; István Láng, IBCSG and National Institute of Oncology, Budapest, Hungary; Marc Debled, Institut Bergonié, Bordeaux, France; Bent Ejlertsen, Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen, Denmark; Roger von Moos, Cantonal Hospital Graubuenden, Chur; Swiss Group for Clinical Cancer Research and IBCSG; Manuela Rabaglio, IBCSG Coordinating Center and Inselspital, Bern; Beat Thürlimann, Breast Center St. Gallen, Kantonsspital, St. Gallen; Swiss Group for Clinical Cancer Research and IBCSG, Bern, Switzerland; Ian Smith, The Royal Marsden Hospital, London, United Kingdom; and Alan S. Coates, IBCSG and University of Sydney School of Public Health, Sydney, Australia.
authors.forename: Richard D
authors.initials: RD
authors.lastname: Gelber
authors.affiliation: Signe Borgquist and Judy E. Garber, Dana-Farber Cancer Institute, Harvard Medical School; Anita Giobbie-Hurder, International Breast Cancer Study Group (IBCSG) Statistical Center, Dana-Farber Cancer Institute; Richard D. Gelber, IBCSG Statistical Center, Dana-Farber Cancer Institute, Harvard Medical School, T.H. Chan Harvard School of Public Health, and Frontier Science and Technology Research Foundation; Karen N. Price, IBCSG Statistical Center and Frontier Science and Technology Research Foundation; Meredith M. Regan, IBCSG Statistical Center, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, MA; Signe Borgquist, Lund University, Lund, Sweden; Thomas P. Ahern, University of Vermont, Burlington, VT; Marco Colleoni and Aron Goldhirsch, IBCSG and European Institute of Oncology, Milan, Italy; István Láng, IBCSG and National Institute of Oncology, Budapest, Hungary; Marc Debled, Institut Bergonié, Bordeaux, France; Bent Ejlertsen, Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen, Denmark; Roger von Moos, Cantonal Hospital Graubuenden, Chur; Swiss Group for Clinical Cancer Research and IBCSG; Manuela Rabaglio, IBCSG Coordinating Center and Inselspital, Bern; Beat Thürlimann, Breast Center St. Gallen, Kantonsspital, St. Gallen; Swiss Group for Clinical Cancer Research and IBCSG, Bern, Switzerland; Ian Smith, The Royal Marsden Hospital, London, United Kingdom; and Alan S. Coates, IBCSG and University of Sydney School of Public Health, Sydney, Australia.
authors.forename: Meredith M
authors.initials: MM
authors.lastname: Regan
authors.affiliation: Signe Borgquist and Judy E. Garber, Dana-Farber Cancer Institute, Harvard Medical School; Anita Giobbie-Hurder, International Breast Cancer Study Group (IBCSG) Statistical Center, Dana-Farber Cancer Institute; Richard D. Gelber, IBCSG Statistical Center, Dana-Farber Cancer Institute, Harvard Medical School, T.H. Chan Harvard School of Public Health, and Frontier Science and Technology Research Foundation; Karen N. Price, IBCSG Statistical Center and Frontier Science and Technology Research Foundation; Meredith M. Regan, IBCSG Statistical Center, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, MA; Signe Borgquist, Lund University, Lund, Sweden; Thomas P. Ahern, University of Vermont, Burlington, VT; Marco Colleoni and Aron Goldhirsch, IBCSG and European Institute of Oncology, Milan, Italy; István Láng, IBCSG and National Institute of Oncology, Budapest, Hungary; Marc Debled, Institut Bergonié, Bordeaux, France; Bent Ejlertsen, Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen, Denmark; Roger von Moos, Cantonal Hospital Graubuenden, Chur; Swiss Group for Clinical Cancer Research and IBCSG; Manuela Rabaglio, IBCSG Coordinating Center and Inselspital, Bern; Beat Thürlimann, Breast Center St. Gallen, Kantonsspital, St. Gallen; Swiss Group for Clinical Cancer Research and IBCSG, Bern, Switzerland; Ian Smith, The Royal Marsden Hospital, London, United Kingdom; and Alan S. Coates, IBCSG and University of Sydney School of Public Health, Sydney, Australia.
authors.forename: Beat
authors.initials: B
authors.lastname: Thürlimann
mesh_terms: D000368:Aged; D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000737:chemistry / Q000188:drug therapy*; D017024:Chemotherapy, Adjuvant; D002784:Cholesterol / Q000097:blood*; D018572:Disease-Free Survival; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006937:Hypercholesterolemia / Q000188:drug therapy; D000077289:Letrozole; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D009570:Nitriles / Q000008:administration & dosage; D016016:Proportional Hazards Models; D018714:Radiotherapy, Adjuvant; D011960:Receptors, Estrogen / Q000032:analysis; D011980:Receptors, Progesterone / Q000032:analysis; D013629:Tamoxifen / Q000008:administration & dosage; D014230:Triazoles / Q000008:administration & dosage
chemical_list: D000924:Anticholesteremic Agents; D009570:Nitriles; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D014230:Triazoles; D013629:Tamoxifen; D000077289:Letrozole; D002784:Cholesterol