Publication
Patterns of recurrence of early breast cancer according to estrogen receptor status: a therapeutic target for a quarter of a century
Journal Paper/Review - Sep 1, 2009
Pagani Olivia, Goldhirsch Aron, Coates Alan S, Fey Martin F, Collins John, Thürlimann Beat, Lindtner Jurij, Holmberg Stig B, Castiglione-Gertsch Monica, Gelber Richard D, Price Karen N, International Breast Cancer Study Group (IBCSG)
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Issn Electronic
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Brief description/objective
The current therapeutic strategy in breast cancer is to identify a target, such as estrogen receptor (ER) status, for tailoring treatments. We investigated the patterns of recurrence with respect to ER status for patients treated in two randomized trials with 25 years' median follow-up. In the ER-negative subpopulations most breast cancer events occurred within the first 5-7 years after randomization, while in the ER-positive subpopulations breast cancer events were spread through 10 years. In the ER-positive subpopulation, 1 year endocrine treatment alone significantly prolonged disease-free survival (DFS) with no additional benefit observed by adding 1 year of chemotherapy. In the small ER-negative subpopulation chemo-endocrine therapy had a significantly better DFS than endocrine alone or no treatment. Despite small numbers of patients, "old-fashioned" treatments, and competing causes of treatment failure, the value of ER status as a target for response to adjuvant treatment is evident through prolonged follow-up.