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Factors associated with late recurrence after completion of 5-year adjuvant tamoxifen in estrogen receptor positive breast cancer

BACKGROUND: Recent large trials have shown the survival benefits of 10-year use of tamoxifen by reducing late recurrence compared with 5-year therapy in estrogen receptor(ER)-positive breast cancer. We tried to identify clinical factors associated with the late recurrence. METHODS: We reviewed our d...

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Autores principales: Lee, Eun-Shin, Han, Wonshik, Kim, Min Kyoon, Kim, Jongjin, Yoo, Tae-kyung, Lee, Moo Hyun, Lee, Kyung Hun, Kim, Tae Yong, Moon, Hyeong-Gon, Im, Seock-Ah, Noh, Dong-Young, Lee, Eun Sook
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4937609/
https://www.ncbi.nlm.nih.gov/pubmed/27388210
http://dx.doi.org/10.1186/s12885-016-2423-x
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author Lee, Eun-Shin
Han, Wonshik
Kim, Min Kyoon
Kim, Jongjin
Yoo, Tae-kyung
Lee, Moo Hyun
Lee, Kyung Hun
Kim, Tae Yong
Moon, Hyeong-Gon
Im, Seock-Ah
Noh, Dong-Young
Lee, Eun Sook
author_facet Lee, Eun-Shin
Han, Wonshik
Kim, Min Kyoon
Kim, Jongjin
Yoo, Tae-kyung
Lee, Moo Hyun
Lee, Kyung Hun
Kim, Tae Yong
Moon, Hyeong-Gon
Im, Seock-Ah
Noh, Dong-Young
Lee, Eun Sook
author_sort Lee, Eun-Shin
collection PubMed
description BACKGROUND: Recent large trials have shown the survival benefits of 10-year use of tamoxifen by reducing late recurrence compared with 5-year therapy in estrogen receptor(ER)-positive breast cancer. We tried to identify clinical factors associated with the late recurrence. METHODS: We reviewed our database of ER-positive patients who had received operations between 1996 and 2006 in two institutions. We selected 444 who had completed 5-year tamoxifen and were disease-free up to 10 years after the operation. Patients who had received aromatase inhibitors with any regimens were excluded. As a late recurrence group, 139 patients were identified who had completed 5-year tamoxifen, but had recurrence afterwards. Among them, 61 had local/contralateral breast recurrence and 78 had distant metastasis. The median follow-up was 9.7 years. Clinicopathological factors at the time of initial operation, such as age, menopausal status, progesterone receptor expression, HER2 status, tumor grade and Ki-67, were compared between the disease-free group and the late recurrence group. RESULTS: In a univariate analysis, tumor size (>2 cm), lymph node metastasis and high histologic grade were significantly associated with late recurrences (p < 0.05). In a multivariate analysis, only axillary lymph node metastasis was significant (p < 0.001). Late distant metastasis was significantly associated with tumor size and axillary lymph node metastasis (p = 0.038, p < 0.001,respectively). Late local/contralateral breast recurrence was associated with axillary lymph node metastasis (p = 0.042). CONCLUSIONS: Our data showed axillary lymph node metastasis at initial operation was the only risk factor of late recurrence after completion of tamoxifen for 5 years. Our results can be helpful in making decisions to use extended tamoxifen beyond 5 years. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12885-016-2423-x) contains supplementary material, which is available to authorized users.
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spelling pubmed-49376092016-07-09 Factors associated with late recurrence after completion of 5-year adjuvant tamoxifen in estrogen receptor positive breast cancer Lee, Eun-Shin Han, Wonshik Kim, Min Kyoon Kim, Jongjin Yoo, Tae-kyung Lee, Moo Hyun Lee, Kyung Hun Kim, Tae Yong Moon, Hyeong-Gon Im, Seock-Ah Noh, Dong-Young Lee, Eun Sook BMC Cancer Research Article BACKGROUND: Recent large trials have shown the survival benefits of 10-year use of tamoxifen by reducing late recurrence compared with 5-year therapy in estrogen receptor(ER)-positive breast cancer. We tried to identify clinical factors associated with the late recurrence. METHODS: We reviewed our database of ER-positive patients who had received operations between 1996 and 2006 in two institutions. We selected 444 who had completed 5-year tamoxifen and were disease-free up to 10 years after the operation. Patients who had received aromatase inhibitors with any regimens were excluded. As a late recurrence group, 139 patients were identified who had completed 5-year tamoxifen, but had recurrence afterwards. Among them, 61 had local/contralateral breast recurrence and 78 had distant metastasis. The median follow-up was 9.7 years. Clinicopathological factors at the time of initial operation, such as age, menopausal status, progesterone receptor expression, HER2 status, tumor grade and Ki-67, were compared between the disease-free group and the late recurrence group. RESULTS: In a univariate analysis, tumor size (>2 cm), lymph node metastasis and high histologic grade were significantly associated with late recurrences (p < 0.05). In a multivariate analysis, only axillary lymph node metastasis was significant (p < 0.001). Late distant metastasis was significantly associated with tumor size and axillary lymph node metastasis (p = 0.038, p < 0.001,respectively). Late local/contralateral breast recurrence was associated with axillary lymph node metastasis (p = 0.042). CONCLUSIONS: Our data showed axillary lymph node metastasis at initial operation was the only risk factor of late recurrence after completion of tamoxifen for 5 years. Our results can be helpful in making decisions to use extended tamoxifen beyond 5 years. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12885-016-2423-x) contains supplementary material, which is available to authorized users. BioMed Central 2016-07-07 /pmc/articles/PMC4937609/ /pubmed/27388210 http://dx.doi.org/10.1186/s12885-016-2423-x Text en © The Author(s). 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Lee, Eun-Shin
Han, Wonshik
Kim, Min Kyoon
Kim, Jongjin
Yoo, Tae-kyung
Lee, Moo Hyun
Lee, Kyung Hun
Kim, Tae Yong
Moon, Hyeong-Gon
Im, Seock-Ah
Noh, Dong-Young
Lee, Eun Sook
Factors associated with late recurrence after completion of 5-year adjuvant tamoxifen in estrogen receptor positive breast cancer
title Factors associated with late recurrence after completion of 5-year adjuvant tamoxifen in estrogen receptor positive breast cancer
title_full Factors associated with late recurrence after completion of 5-year adjuvant tamoxifen in estrogen receptor positive breast cancer
title_fullStr Factors associated with late recurrence after completion of 5-year adjuvant tamoxifen in estrogen receptor positive breast cancer
title_full_unstemmed Factors associated with late recurrence after completion of 5-year adjuvant tamoxifen in estrogen receptor positive breast cancer
title_short Factors associated with late recurrence after completion of 5-year adjuvant tamoxifen in estrogen receptor positive breast cancer
title_sort factors associated with late recurrence after completion of 5-year adjuvant tamoxifen in estrogen receptor positive breast cancer
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4937609/
https://www.ncbi.nlm.nih.gov/pubmed/27388210
http://dx.doi.org/10.1186/s12885-016-2423-x
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