Tamoxifen or surgery plus tamoxifen as primary treatment for elderly patients with operable breast cancer: the G.R.E.T.A. Trial. Group for Research on Endocrine Therapy in the Elderly
Mustacchi, G.; Milani, S.; Pluchinotta, A.; De Matteis, A.; Rubagotti, A.; Perrota, A.
Anticancer Research 14(5b): 2197-2200
1994
ISSN/ISBN: 0250-7005 PMID: 7840523 Document Number: 436358
A multicentre trial in operable breast cancer in patients aged over 70 years compared tamoxifen alone (starting with a loading dose of 160 mg on the first day) with surgery plus adjuvant tamoxifen. 473 patients were recruited with a median follow up of 36 months. Local progression occurred in 15/237 patients in the surgical arm versus 60/236 in the tamoxifen alone arm (p = 0.000). There were 48 deaths in the surgical arm and 41 in the other one (p = 0.67). Distant metastases occurred in 33/237 patients in the surgical arm versus 19/236 in the tamoxifen alone arm (p = 0.058). In elderly patients with operable breast cancer surgery is indicated. Tamoxifen alone is an adequate alternative in frail patients. A loading dose of Tamoxifen may be useful in preventing the expression of the metastatizing phenotype. In any case, delayed surgery does not prejudice the overall survival.