Evidence map›Paper›PMID 38967128›Full record

Trial reportActa oncologica (Stockholm, Sweden)2024

Breast cancer hormone receptor levels and benefit from adjuvant tamoxifen in a randomized trial with long-term follow-up.

Helena Fohlin, Anna Nordenskjöld, Johan Rosell, Mårten Fernö, Tommy Fornander, Lisa Rydén, Lambert Skoog, Bo Nordenskjöld, Olle Stål

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Acta oncologica (Stockholm, Sweden), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Trial
  2. Article
  3. Review
  4. Article
  5. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Helena Fohlin *Regional Cancer Center South-East Sweden and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden. helena.fohlin@regionostergotland.se.
Anna Nordenskjöld *Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, Sahlgrenska University Hospital, Gothenburg Sweden.
Johan RosellRegional Cancer Center South-East Sweden and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
Mårten FernöDivision of Oncology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
Tommy FornanderDepartment of Oncology and Pathology, Karolinska Institute, Stockholm, Sweden.
Lisa RydénDepartment of Clinical Sciences Lund, Division of Surgery, Lund University, Lund, Sweden.
Lambert SkoogDepartment of Oncology and Pathology, Karolinska Institute, Stockholm, Sweden.
Bo Nordenskjöld *Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
Olle Stål *Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHormone receptor positivity predicts benefit from endocrine therapy but the knowledge about the long-term survival of patients with different tumor receptor levels is limited. In this study, we describe the 25 years outcome of tamoxifen (TAM) treated patients. PATIENTS AND

methodsBetween 1983 and 1992, a total of 4,610 postmenopausal patients with early-stage breast cancer were randomized to receive totally 2 or 5 years of TAM therapy. After 2 years, 4,124 were alive and free of breast cancer recurrence. Among these, 2,481 had demonstrated estrogen receptor positive (ER+) disease. From 1988, the Abbot enzyme immunoassay became available and provided quantitative receptor levels for 1,210 patients, for which our analyses were done.

resultsAfter 5 years of follow-up, when all TAM treatment was finished, until 15 years of follow-up, breast cancer mortality for patients with ER+ disease was significantly reduced in the 5-year group as compared with the 2-year group (hazard ratios [HR] 0.67, 95% confidence intervals [CI] 0.55-0.83, p < 0.001). After 15 years, the difference between the groups remained but did not increase further. A substantial benefit from prolonged TAM therapy was only observed for the subgroup of patients with ER levels below the median (HR = 0.62, 95% CI 0.46-0.84, p = 0.002). Similarly, patients with progesterone receptor negative (PR-) disease did benefit from prolonged TAM treatment. For patients with progesterone receptor positive (PR+) disease, there was no statistically significant benefit from more than 2 years of TAM.  Interpretation: As compared with 2 years of adjuvant TAM, 5 years significantly prolonged breast cancer-specific survival. The benefit from prolonged TAM therapy was statistically significant for patients with ER levels below median or PR-negative disease. There was no evident benefit from prolonged TAM for patients with high ER levels or with PR+ tumors.

Indexed as

Antineoplastic Agents, HormonalBreast NeoplasmsReceptors, EstrogenReceptors, ProgesteroneTamoxifenAdultAgedChemotherapy, AdjuvantFemaleFollow-Up StudiesHumansMiddle AgedPostmenopauseTreatment OutcomeAntineoplastic Agents, HormonalReceptors, EstrogenReceptors, ProgesteroneTamoxifen

Identifiers

PMID38967128
PMCPMC11332493

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.