Trial reportJournal of the National Cancer Institute2026
Tamoxifen therapy benefit in luminal A and B breast cancer with 20-year follow-up.
Trial report in Journal of the National Cancer Institute, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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.
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1 citing paper in PubMed.
- Nuclear SOX9 Expression and Short-Term Survival Outcomes in Early-Stage Luminal Breast Cancer: An Immunohistochemical and Retrospective Cohort Analysis.International journal of molecular sciences · 2026Article
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Abstract
backgroundPatients with estrogen receptor-positive breast cancer have a substantial late risk of distant recurrence, but the long-term subtype-specific tamoxifen benefit remains poorly understood.
methodsA secondary analysis of the Stockholm Tamoxifen randomized trials (1976-1997, n = 3930) with 20-year follow-up was conducted. Formalin-fixed, paraffin-embedded blocks were available for 2250 patients. A total of 952 patients with estrogen receptor-positive and HER2-negative tumors, classified as luminal A (n = 688) and luminal B (n = 264) using Agilent microarrays, were analyzed. Patients were randomly assigned to at least 2 years of tamoxifen therapy or no endocrine therapy. Distant recurrence-free interval was assessed by Kaplan-Meier analysis and multivariable Cox proportional hazards regression.
resultsPatients with luminal A tumors had low early risk and modest early benefit from tamoxifen therapy (5-year distant recurrence-free interval treated vs control: 93% vs 89%; absolute difference = 4%) that increased over the 20-year follow-up (20-year distant recurrence-free interval: 76% vs 66%; absolute difference = 10%), highlighting long-term benefit. In contrast, patients with luminal B tumors had larger early risk and treatment benefit (5-year distant recurrence-free interval: 72% vs 57%; absolute difference = 15%), which remained stable over time (20-year distant recurrence-free interval: 55% vs 37%; absolute difference = 18%). Multivariable analyses showed that luminal patients benefited from tamoxifen therapy (luminal A: adjusted hazard ratio [HR] = 0.57, 95% confidence interval [CI] = 0.42 to 0.78; luminal B: adjusted HR = 0.68, 95% CI = 0.46 to 0.99). Patients with favorable tumor characteristics benefited regardless of luminal subtype.
conclusionsTamoxifen reduces the long-term risk of distant recurrence in luminal A and B tumors, although timing of benefit varies by subtype. Even after treatment, patients with luminal tumors have a substantial late risk, highlighting the need for long-term follow-up. CLINICAL
trial registrationThe trial center for the Stockholm Tamoxifen trials was the Regional Cancer Center Stockholm-Gotland, in Stockholm, Sweden. The start of the Stockholm Tamoxifen trials in 1976 was before the custom of trial registration started in Sweden, therefore no trial number is available.
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