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Goserelin plus tamoxifen compared to chemotherapy followed by tamoxifen in premenopausal patients with early stage-, lymph node-negative breast cancer of luminal A subtype.
- Source :
-
Breast (Edinburgh, Scotland) [Breast] 2016 Dec; Vol. 30, pp. 111-117. Date of Electronic Publication: 2016 Sep 30. - Publication Year :
- 2016
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Abstract
- Objectives: To study the outcomes of adjuvant goserelin combined with tamoxifen (GosTam) compared to chemotherapy followed by tamoxifen (ChemTam) in premenopausal patients with early stage, luminal A breast cancer.<br />Methods: From 2008 until 2013, data were retrospectively collected for premenopausal patients who underwent surgery for invasive tumors that were ≤2.0 cm, node-negative, strongly positive for estrogen and progesterone receptors, HER-2-negative, and Ki-67 < 25%. The patients were divided into two groups according to adjuvant regimen, either GosTam or ChemTam. All patients who underwent different adjuvant regimens were excluded.<br />Results: In total, 235 patients underwent GosTam and 171 patients underwent ChemTam. There were significantly more patients younger than 40 years in the GosTam group (32% GosTam vs. 22% ChemTam, p = 0.031). Mean tumor size was significantly smaller (1.19 cm vs. 1.48 cm, p < 0.001), Ki-67 significantly lower (p = 0.049), and nuclear grade was low in a significant number of patients in the GosTam group (2% vs. 13%, p < 0.001). After a median follow-up of 51.3 months, there was no mortality in either group. There was no significant difference in 5-year disease-free survival (DFS) between the two groups even after univariate analysis considering age, tumor size, nuclear grade, and P53% (GosTam = 98.9% vs. ChemTam = 95.7%, HR = 0.404, 95% CI = [0.073, 2.222], p = 0.248).<br />Conclusion: There was no difference between treatment groups, and neither chemotherapy nor ovarian suppression seemed to improve the outcome. Thus, tamoxifen alone might be a sufficient option for this low-risk patient population.<br /> (Copyright © 2016 Elsevier Ltd. All rights reserved.)
- Subjects :
- Adult
Antineoplastic Agents, Hormonal administration & dosage
Breast Neoplasms classification
Breast Neoplasms metabolism
Breast Neoplasms pathology
Carcinoma, Ductal, Breast classification
Carcinoma, Ductal, Breast metabolism
Carcinoma, Ductal, Breast pathology
Carcinoma, Lobular classification
Carcinoma, Lobular metabolism
Carcinoma, Lobular pathology
Chemotherapy, Adjuvant
Cyclophosphamide therapeutic use
Doxorubicin therapeutic use
Female
Fluorouracil therapeutic use
Goserelin administration & dosage
Humans
Lymph Nodes pathology
Mastectomy
Middle Aged
Neoplasm Staging
Premenopause
Receptor, ErbB-2 metabolism
Receptors, Estrogen metabolism
Receptors, Progesterone metabolism
Retrospective Studies
Tamoxifen administration & dosage
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Breast Neoplasms drug therapy
Carcinoma, Ductal, Breast drug therapy
Carcinoma, Lobular drug therapy
Mastectomy, Segmental
Subjects
Details
- Language :
- English
- ISSN :
- 1532-3080
- Volume :
- 30
- Database :
- MEDLINE
- Journal :
- Breast (Edinburgh, Scotland)
- Publication Type :
- Academic Journal
- Accession number :
- 27697675
- Full Text :
- https://doi.org/10.1016/j.breast.2016.08.011