Abstract
We have examined the outcome of older patients with operable breast cancer treated
in a randomised trial by either standard surgery or less extensive surgery and tamoxifen.
There were 236 participants aged ⩾70 years, randomised to either modified radical
mastectomy MRM (n=120) or wide local excision (WLE) and tamoxifen (T) 20 mg daily (n=116). Survival curves were estimated using the Kaplan–Meier method and multivariate
analyses were performed using Cox's proportional hazards model. Endpoints were survival
and time to first relapse or progression, loco-regional progression, time to distant
progression and progression-free survival. No significant difference was seen in terms
of progression-free survival, but there were significantly more loco-regional relapses
in the WLE+T group. In contrast, there were more distant metastases in the MRM group,
but with a similar overall survival in both groups. The results of this trial give
cautious support for the use of WLE+T for selected older women.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to European Journal of CancerAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Cancer in the European Community and its member states.Eur. J. Cancer. 1990; 26: 1167-1256
- Breast carcinoma in the extremes of age.J. Surg. Oncol. 1985; 28: 90-96
- Histopathology in relation to age.Br. J. Cancer. 1997; 75: 593-596
- Patterns of care related to age of breast cancer patients.JAMA. 1987; 257: 2766-2770
- The effect of age and comorbidity in the treatment of elderly women with non-metastatic breast cancer.Arch. Intern. Med. 1996; 156: 85-90
- Tamoxifen as initial sole treatment of localised breast cancer in elderly women.Br. Med. J. 1982; 284: 869-870
- Tamoxifen as primary treatment in elderly or frail patients.Br. Med. J. 1985; 290: 358
- Treatment of primary breast cancer with Nolvadex alone.Rev. Endocr. Rel. Cancer. 1985; : 77-80
- Antioestrogen treatment of postmenopausal women with primary high risk breast cancer.Breast Cancer Res. Treat. 1983; 3: 77-84
- How to establish equivalence when data are censored.Statistics in Medicine. 1993; 12: 1353-1364
- Tamoxifen for early breast cancer.Lancet. 1998; 351: 1451-1467
- Prospective randomised trial of tamoxifen versus surgery in elderly patients with breast cancer.Lancet. 1988; I: 679-681
- Comparison of mastectomy with tamoxifen for treating elderly patients with operable breast cancer.Br. Med. J. 1988; 297: 311-314
- Breast cancer in elderly women.Br. J. Surg. 1991; 78: 591-594
- Breast cancer, tamoxifen and surgery.Lancet. 1988; I: 1044
- Prospective randomised trial of tamoxifen versus surgery in elderly patients with breast cancer.Eur. J. Surg. Oncol. 1994; 20: 207-214
- Mastectomy or tamoxifen as initial therapy for operable breast cancer in elderly patients.Eur. J. Cancer. 1992; 28A: 908-910
- Long-term follow-up of elderly patients randomised to primary tamoxifen or wedge mastectomy as initial therapy for operable breast cancer.The Breast. 1998; 7: 335-339
Bates T, Fennessy M, Riley DJ, Baum M, Houghton J. Breast cancer in the elderly: surgery improves survival. The results of the Cancer Research Campaign Trial. Eur. J. Cancer 2001, 37 Suppl. 5.
- Tamoxifen or surgery plus tamoxifen as primary treatment for elderly patients with operable breast cancer.Anticancer Res. 1994; 14: 197-200
- Relationship between immunohistochemical estimation of oestrogen receptors in elderly patients with primary operable breast cancer in response to tamoxifen.Lancet. 1989; I: 1044-1046
Article info
Publication history
Accepted:
August 30,
2002
Received:
August 16,
2002
Identification
Copyright
© 2003 Elsevier Science Ltd. Published by Elsevier Inc. All rights reserved.
