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Lectures in Early Breast Cancer A PowerPoint slide set based on images from: Lectures in Early Breast Cancer Part 3: Adjuvant Therapy in Early Breast Cancer
Lectures in Early Breast CancerA PowerPoint slide set based on images from:Lectures in Early Breast Cancer Part 3:Adjuvant Therapy in Early Breast Cancer
Lectures inEarly Breast Cancer
Reproduced with permission from the EBCTCG (2005).
Lectures inEarly Breast Cancer
Participants (n=10,386) had either oestrogen receptor (ER)-positive or ER-unknown disease: 20% ER-unknown, 30% node-positive. Error bars are ±1SE.
Reproduced with permission from the EBCTCG (2005).
Lectures inEarly Breast Cancer
*Odds ratio calculated instead of hazard ratio. A, anastrozole; T, tamoxifen; HR+, hormone-receptor-positive.
Reproduced with permission from Howell et al. (2005).
Lectures inEarly Breast Cancer
The second non-breast cancers included endometrial cancer (6 patients in the letrozole group and 15 patients in the tamoxifen group), colon cancer (8 and 13 patients, respectively), lung cancer (5 and 8 patients), ovarian cancer (4 and 8 patients), renal cancer (4 and 8 patients) and other types (42 and 30 patients). Causes of death without a prior cancer event included cerebrovascular accident (7 patients in the letrozole group and 1 patient in the tamoxifen group), thromboembolic event (2 patients in each group), cardiac causes (13 and 6 patients, respectively), sudden death of unknown cause (10 patients in each group), and other causes (23 and 19 patients, respectively). Patients with multiple causes of death were classified as having ‘other causes’. Two-sided p values for the cumulative incidence were calculated with the use of Gray's test.
Reproduced with permission from Thurlimann et al. (2005).
Lectures inEarly Breast Cancer
*A disease-free survival event was defined as the first of any of the following events: any breast-cancer recurrence; a new invasive cancer in the contralateral breast; a second non-breast cancer; or death without a prior cancer event.
Reproduced with permission from Thurlimann et al. (2005).
Lectures inEarly Breast Cancer
Reproduced with permission from Jakesz et al. (2005).
Lectures inEarly Breast Cancer
Data taken from Coombes et al. (2006) and Kaufman et al. (2006).
Lectures inEarly Breast Cancer
Of breast cancer recurrences, 60% occur more than 5 years postsurgery. Annual risk of late recurrence is particularly high in oestrogen-receptor-positive (ER+) tumours. PgR+, progesterone-receptor-positive.
Reproduced with permission from Saphner et al. (1996).
Lectures inEarly Breast Cancer
Reproduced from the EBCTCG (2005).
Lectures inEarly Breast Cancer
Reproduced with permission from Ingle et al. (2001).
Lectures inEarly Breast Cancer
*In favour of tamoxifen. †n=2229 for anastrozole, 2236 for tamoxifen, excluding patients with hysterectomy at baseline, recorded at any time. ‡Patients with one or more fractures occurring at any time before recurrence (includes patients no longer receiving treatment). §Patients may have had one or more fractures at difference sites.
Reproduced with permission from Howell et al. (2005).
Lectures inEarly Breast Cancer
Reproduced with permission from Dowsett et al. (2005).
ReferencesCoombes RC, Paridaens R, Jassem J et al. First mature survival analysis of the Intergroup Exemestane Study: a randomised trial in disease-free, postmenopausal patients with early breast cancer randomised to continue tamoxifen or switch to exemestane following an initial 2–3 years of adjuvant tamoxifen. J Clin Oncol 2006; 24(18, Suppl):LBA527.
Dowsett M, Cuzick J, Wale C et al. Retrospective analysis of time to recurrence in the ATAC trial according to hormone receptor status: an hypothesis-generating study. J Clin Oncol 2005; 23:7512–7517.
Early Breast Cancer Trialists' Collaborative Group (EBCTCG). Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials. Lancet 2005; 365:1687–1717.
Howell A, Cuzick J, Baum M et al; ATAC Trialists' Group. Results of the ATAC (Arimidex, Tamoxifen, Alone or in Combination) trial after completion of 5 years' adjuvant treatment for breast cancer. Lancet 2005; 365:60–62.
Ingle J, Tu D, Pater JL et al. Duration of letrozole treatment and outcomes in the placebo-controlled NCIC CTG MA.17 extended adjuvant therapy trial. Breast Cancer Res Treat 2006; 16:1–6.
Jakesz R, Jonat W, Gnant M et al; on behalf of the ABCSG and the GABG. Switching of postmenopausal women with endocrine-responsive early breast cancer to anastrozole after 2 years' adjuvant tamoxifen: combined results of ABCSG trial 8 and ARNO 95 trial. Lancet 2005; 366:455–462.
Kaufman M, Jonat W, Hilfrich J et al; the German Adjuvant Breast Cancer Group. Survival benefit of switching to anastrozole after 2 years' treatment with tamoxifen versus continued tamoxifen. Presented at: 42nd American Society of Clinical Oncology Annual Meeting, Atlanta, GA, 2–6 June, 2006.
Saphner T, Tormey DC, Gray R et al. Annual hazard rates of recurrence for breast cancer after primary therapy. J Clin Oncol 1996; 14:2738–2746.
Thurlimann B, Keshaviah A, Coates AS et al; The Breast International Group (BIG) 1-98 Collaborative Group. A comparison of letrozole and tamoxifen in postmenopausal women with early breast cancer. N Engl J Med 2005; 353:2747–2757.
