Low-dose tamoxifen in the treatment of breast ductal intraepithelial neoplasia: results of a large observational study.
Ann Oncol
; 21(5): 949-54, 2010 May.
Article
in En
| MEDLINE
| ID: mdl-19858087
ABSTRACT
BACKGROUND:
Tamoxifen's cost-benefit ratio for breast ductal intraepithelial neoplasia (DIN) is unclear. Since low-dose tamoxifen showed a favorable modulation of breast cancer biomarkers in phase II trials, a monoinstitutional cohort of women with DIN treated with low-dose tamoxifen or no systemic treatment was analyzed. PATIENTS ANDMETHODS:
A total of 309 patients with DIN received low-dose tamoxifen as part of institutional guidelines and were compared with 371 patients with DIN who received no systemic treatment after surgery.RESULTS:
Women with estrogen receptor (ER)/progesterone receptor (PgR) >50% DIN who were not treated had a higher incidence of breast events than women on tamoxifen [hazard ratio (HR) 1.76; 95% confidence interval (CI) 1.00-3.12] or women with ER/PgR <50% DIN (HR 1.72; 95% CI 1.14-2.58). Among untreated patients with ER >50% DIN, recurrence was higher in PgR > or =50% DIN than in PgR <50% DIN, whereas it was similar among low PgR (<50%) DIN against which tamoxifen had no effect. No difference in endometrial cancer incidence was noted.CONCLUSIONS:
High ER and especially high PgR expression is a significant adverse prognostic indicator of DIN, and low-dose tamoxifen appears to be an active treatment. Women with low-expression ER or PgR DIN do not seem to benefit from tamoxifen. A definitive clinical trial is warranted.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Tamoxifen
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Breast Neoplasms
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Carcinoma in Situ
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Carcinoma, Ductal, Breast
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Antineoplastic Agents, Hormonal
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Neoplasm Recurrence, Local
Type of study:
Etiology_studies
/
Guideline
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limits:
Adult
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Aged
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Aged80
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Female
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Humans
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Middle aged
Language:
En
Journal:
Ann Oncol
Year:
2010
Document type:
Article