Lumpectomy plus tamoxifen with or without irradiation in women 70 years of age or older with early breast cancer

Kevin S. Hughes, Lauren A. Schnaper, Donald Berry, Constance Cirrincione, Beryl McCormick, Brenda Shank, Judith Wheeler, Lorraine A. Champion, Thomas J. Smith, Barbara L. Smith, Charles Shapiro, Hyman B. Muss, Eric Winer, Clifford Hudis, William Wood, David Sugarbaker, I. Craig Henderson, Larry Norton

Research output: Contribution to journalArticlepeer-review

896 Scopus citations

Abstract

BACKGROUND: In women 70 years of age or older who have early breast cancer, it is unclear whether lumpectomy plus tamoxifen is as effective as lumpectomy followed by tamoxifen plus radiation therapy. METHODS: Between July 1994 and February 1999, we randomly assigned 636 women who were 70 years of age or older and who had clinical stage I (T1N0M0 according to the tumor-node-metastasis classification), estrogen-receptor-positive breast carcinoma treated by lumpectomy to receive tamoxifen plus radiation therapy (317 women) or tamoxifen alone (319 women). Primary end points were the time to local or regional recurrence, the frequency of mastectomy for recurrence, breast-cancer-specific survival, the time to distant metastasis, and overall survival. RESULTS: The only significant difference between the two groups was in the rate of local or regional recurrence at five years (1 percent in the group given tamoxifen plus irradiation and 4 percent in the group given tamoxifen alone, P<0.001). There were no significant differences between the two groups with regard to the rates of mastectomy for local recurrence, distant metastases, or five-year rates of overall survival (87 percent in the group given tamoxifen plus irradiation and 86 percent in the tamoxifen group, P=0.94). Assessment by physicians and patients of cosmetic results and adverse events uniformly rated tamoxifen plus irradiation inferior to tamoxifen alone. CONCLUSIONS: Lumpectomy plus adjuvant therapy with tamoxifen alone is a realistic choice for the treatment of women 70 years of age or older who have early, estrogen-receptor-positive breast cancer.

Original languageEnglish
Pages (from-to)971-977
Number of pages7
JournalNew England Journal of Medicine
Volume351
Issue number10
DOIs
StatePublished - 2 Sep 2004
Externally publishedYes

Fingerprint

Dive into the research topics of 'Lumpectomy plus tamoxifen with or without irradiation in women 70 years of age or older with early breast cancer'. Together they form a unique fingerprint.

Cite this