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    Predictors of early relapse in postmenopausal women with hormone receptor-positive breast cancer in the BIG 1-98 trial.

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    Authors
    Mauriac, Louis
    Keshaviah, Aparna
    Debled, M
    Mouridsen, Henning
    Forbes, John F
    Thürlimann, Beat
    Paridaens, Robert
    Monnier, A
    Láng, I
    Wardley, Andrew M
    Nogaret, Jean-Marie
    Gelber, Richard D
    Castiglione-Gertsch, Monica
    Price, Karen N
    Coates, Alan S
    Smith, Ian
    Viale, G
    Rabaglio, Manuela
    Zabaznyi, N
    Goldhirsch, Aron
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    Affiliation
    French Breast Cancer Group, Institut Bergonié Bordeaux, France. mauriac@bergonie.org
    Issue Date
    2007-05
    
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    Abstract
    BACKGROUND: Aromatase inhibitors are considered standard adjuvant endocrine treatment of postmenopausal women with hormone receptor-positive breast cancer, but it remains uncertain whether aromatase inhibitors should be given upfront or sequentially with tamoxifen. Awaiting results from ongoing randomized trials, we examined prognostic factors of an early relapse among patients in the BIG 1-98 trial to aid in treatment choices. PATIENTS AND METHODS: Analyses included all 7707 eligible patients treated on BIG 1-98. The median follow-up was 2 years, and the primary end point was breast cancer relapse. Cox proportional hazards regression was used to identify prognostic factors. RESULTS: Two hundred and eighty-five patients (3.7%) had an early relapse (3.1% on letrozole, 4.4% on tamoxifen). Predictive factors for early relapse were node positivity (P < 0.001), absence of both receptors being positive (P < 0.001), high tumor grade (P < 0.001), HER-2 overexpression/amplification (P < 0.001), large tumor size (P = 0.001), treatment with tamoxifen (P = 0.002), and vascular invasion (P = 0.02). There were no significant interactions between treatment and the covariates, though letrozole appeared to provide a greater than average reduction in the risk of early relapse in patients with many involved lymph nodes, large tumors, and vascular invasion present. CONCLUSION: Upfront letrozole resulted in significantly fewer early relapses than tamoxifen, even after adjusting for significant prognostic factors.
    Citation
    Predictors of early relapse in postmenopausal women with hormone receptor-positive breast cancer in the BIG 1-98 trial. 2007, 18 (5):859-67 Ann. Oncol.
    Journal
    Annals of Oncology
    URI
    http://hdl.handle.net/10541/71963
    DOI
    10.1093/annonc/mdm001
    PubMed ID
    17301074
    Type
    Article
    Language
    en
    ISSN
    0923-7534
    ae974a485f413a2113503eed53cd6c53
    10.1093/annonc/mdm001
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