Identification of patients with hormone receptor-positive breast cancer who need adjuvant tamoxifen therapy for more than 5 years
Extended hormonal therapy with tamoxifen for > 5 years has improved disease-free survival (DFS) and overall survival (OS) in hormone receptor (HR)-positive breast cancer patients. The aim of this study was to identify the HR-positive breast cancer women who need adjuvant tamoxifen for > 5 year...
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doaj-ed6c8384701f455fa44071a1ec245d412020-11-25T00:03:37ZengElsevierJournal of the Formosan Medical Association0929-66462016-04-01115424925610.1016/j.jfma.2015.03.003Identification of patients with hormone receptor-positive breast cancer who need adjuvant tamoxifen therapy for more than 5 yearsChiao-En Wu0Shin-Cheh Chen1Hsien-Kun Chang2Yung-Feng Lo3Swei Hsueh4Yung-Chang Lin5Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, TaiwanDivision of Breast Surgery, Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, TaiwanDivision of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, TaiwanDivision of Breast Surgery, Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, TaiwanDepartment of Pathology, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, TaiwanDivision of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, TaiwanExtended hormonal therapy with tamoxifen for > 5 years has improved disease-free survival (DFS) and overall survival (OS) in hormone receptor (HR)-positive breast cancer patients. The aim of this study was to identify the HR-positive breast cancer women who need adjuvant tamoxifen for > 5 years. Methods: Between 1990 and 2004, 1104 HR-positive breast cancer patients who had received tamoxifen treatment at our institution and had been disease free for at least 6 years were included in this analysis. Univariate and multivariate analyses of prognostic factors for late recurrence were performed using the binary logistic regression model. Results: During a median follow-up period of 10.9 years after surgery, 70 patients died and 99 showed recurrence. In multivariate analysis, age < 40 years (p < 0.001) and lymph node metastasis (p < 0.001) were associated with higher rates of recurrence. We stratified patients into high-risk (age < 40 years or positive lymph node status, 536 patients) and low-risk (age > 40 years and negative lymph node status, 566 patients) groups. The recurrence rates were 14.6% and 3.5% in the high-risk and low-risk groups, respectively. Patients in the high-risk group had poorer disease-free survival (p < 0.001) and overall survival (p = 0.010) than those in the low-risk group. Conclusion: Our findings suggest that HR-positive breast cancer women either aged < 40 years or with positive lymph node status were justified in continuing with tamoxifen therapy for > 5 years.http://www.sciencedirect.com/science/article/pii/S092966461500131Xadjuvant therapybreast cancerhormonal therapylate recurrencetamoxifen |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Chiao-En Wu Shin-Cheh Chen Hsien-Kun Chang Yung-Feng Lo Swei Hsueh Yung-Chang Lin |
spellingShingle |
Chiao-En Wu Shin-Cheh Chen Hsien-Kun Chang Yung-Feng Lo Swei Hsueh Yung-Chang Lin Identification of patients with hormone receptor-positive breast cancer who need adjuvant tamoxifen therapy for more than 5 years Journal of the Formosan Medical Association adjuvant therapy breast cancer hormonal therapy late recurrence tamoxifen |
author_facet |
Chiao-En Wu Shin-Cheh Chen Hsien-Kun Chang Yung-Feng Lo Swei Hsueh Yung-Chang Lin |
author_sort |
Chiao-En Wu |
title |
Identification of patients with hormone receptor-positive breast cancer who need adjuvant tamoxifen therapy for more than 5 years |
title_short |
Identification of patients with hormone receptor-positive breast cancer who need adjuvant tamoxifen therapy for more than 5 years |
title_full |
Identification of patients with hormone receptor-positive breast cancer who need adjuvant tamoxifen therapy for more than 5 years |
title_fullStr |
Identification of patients with hormone receptor-positive breast cancer who need adjuvant tamoxifen therapy for more than 5 years |
title_full_unstemmed |
Identification of patients with hormone receptor-positive breast cancer who need adjuvant tamoxifen therapy for more than 5 years |
title_sort |
identification of patients with hormone receptor-positive breast cancer who need adjuvant tamoxifen therapy for more than 5 years |
publisher |
Elsevier |
series |
Journal of the Formosan Medical Association |
issn |
0929-6646 |
publishDate |
2016-04-01 |
description |
Extended hormonal therapy with tamoxifen for > 5 years has improved disease-free survival (DFS) and overall survival (OS) in hormone receptor (HR)-positive breast cancer patients. The aim of this study was to identify the HR-positive breast cancer women who need adjuvant tamoxifen for > 5 years.
Methods: Between 1990 and 2004, 1104 HR-positive breast cancer patients who had received tamoxifen treatment at our institution and had been disease free for at least 6 years were included in this analysis. Univariate and multivariate analyses of prognostic factors for late recurrence were performed using the binary logistic regression model.
Results: During a median follow-up period of 10.9 years after surgery, 70 patients died and 99 showed recurrence. In multivariate analysis, age < 40 years (p < 0.001) and lymph node metastasis (p < 0.001) were associated with higher rates of recurrence. We stratified patients into high-risk (age < 40 years or positive lymph node status, 536 patients) and low-risk (age > 40 years and negative lymph node status, 566 patients) groups. The recurrence rates were 14.6% and 3.5% in the high-risk and low-risk groups, respectively. Patients in the high-risk group had poorer disease-free survival (p < 0.001) and overall survival (p = 0.010) than those in the low-risk group.
Conclusion: Our findings suggest that HR-positive breast cancer women either aged < 40 years or with positive lymph node status were justified in continuing with tamoxifen therapy for > 5 years. |
topic |
adjuvant therapy breast cancer hormonal therapy late recurrence tamoxifen |
url |
http://www.sciencedirect.com/science/article/pii/S092966461500131X |
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