Details

Autor(en) / Beteiligte

• Guerrieri-Gonzaga, A.
• Lazzeroni, M.
• Botteri, E.
• Serrano, D.
• Rotmensz, N.
• Varricchio, M.-C.
• Cazzaniga, M.
• Bollani, G.
• Mora, S.
• Montefrancesco, C.
• Pruneri, G.
• Viale, G.
• Intra, M.
• Galimberti, V.
• Goldhirsch, A.
• Bagnardi, V.
• Bonanni, B.
• DeCensi, A.

Titel

Effect of low-dose tamoxifen after surgical excision of ductal intraepithelial neoplasia: results of a large retrospective monoinstitutional cohort study

Ist Teil von

• Annals of oncology, 2013-07, Vol.24 (7), p.1859-1866

Ort / Verlag

Oxford: Elsevier Ltd

Erscheinungsjahr

2013

Quelle

MEDLINE

Beschreibungen/Notizen

• Postsurgical treatment of ductal intraepithelial neoplasia (DIN) with standard doses of tamoxifen has not reached a consensus yet. Given positive results of low-dose tamoxifen on breast cancer biomarkers modulation, we analyzed a large cohort of DIN patients treated with low-dose tamoxifen or no treatment as per institutional guidelines. All consecutive women operated on at the European Institute of Oncology for estrogen receptor (ER)-positive DIN (474 treated with low-dose tamoxifen and 509 untreated patients) were followed up for a median of 7 years. Compared with untreated patients, a significant 30% reduction in breast cancer risk was observed on low-dose tamoxifen with an adjusted hazard ratio (HR) = 0.70 [95% confidence interval (CI) 0.51–0.94], with a greater benefit in postmenopausal (HR = 0.57; 95% CI 0.34–0.94) than in premenopausal women (HR = 0.79; 95% CI 0.54–1.17). Treated patients with ER and progesterone receptor (PgR) >50% DIN had a lower incidence of breast events than untreated ones (HR = 0.61; 95% CI 0.40–0.94), whereas no protective effect has been observed in patients with ER or PgR <50% DIN. Drug discontinuation resulted in a doubled risk of recurrence in premenopausal women only (HR = 1.95; 95% CI 0.98–3.89). No excess of endometrial cancer occurred. Low-dose tamoxifen is a promising and safe strategy for highly endocrine responsive DIN. Treatment adherence is crucial in premenopausal women. A definitive trial is ongoing.