Factors associated with late recurrence after completion of 5-year adjuvant tamoxifen in estrogen receptor positive breast canceropen access
- Authors
- Lee, Eun-Shin; Han, Wonshik; Kim, Min Kyoon; Kim, Jongjin; Yoo, Tae-Kyung; Lee, Moo Hyun; Lee, Kyung Hun; Kim, Tae Yong; Moon, Hyeong-Gon; Im, Seock-Ah; Noh, Dong-Young; Lee, Eun Sook
- Issue Date
- Jul-2016
- Publisher
- BMC
- Keywords
- Estrogen receptor (ER)-positive breast cancer; Late recurrence; Extended tamoxifen
- Citation
- BMC CANCER, v.16
- Journal Title
- BMC CANCER
- Volume
- 16
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/70405
- DOI
- 10.1186/s12885-016-2423-x
- ISSN
- 1471-2407
1471-2407
- Abstract
- Background: Recent large trials have shown the survival benefits of 10-year use of tamoxifen by reducing late recurrence compared with 5-year therapy in estrogen receptor(ER)-positive breast cancer. We tried to identify clinical factors associated with the late recurrence. Methods: We reviewed our database of ER-positive patients who had received operations between 1996 and 2006 in two institutions. We selected 444 who had completed 5-year tamoxifen and were disease-free up to 10 years after the operation. Patients who had received aromatase inhibitors with any regimens were excluded. As a late recurrence group, 139 patients were identified who had completed 5-year tamoxifen, but had recurrence afterwards. Among them, 61 had local/contralateral breast recurrence and 78 had distant metastasis. The median follow-up was 9.7 years. Clinicopathological factors at the time of initial operation, such as age, menopausal status, progesterone receptor expression, HER2 status, tumor grade and Ki-67, were compared between the disease-free group and the late recurrence group. Results: In a univariate analysis, tumor size (>2 cm), lymph node metastasis and high histologic grade were significantly associated with late recurrences (p < 0.05). In a multivariate analysis, only axillary lymph node metastasis was significant (p < 0.001). Late distant metastasis was significantly associated with tumor size and axillary lymph node metastasis (p = 0.038, p < 0.001, respectively). Late local/contralateral breast recurrence was associated with axillary lymph node metastasis (p = 0.042). Conclusions: Our data showed axillary lymph node metastasis at initial operation was the only risk factor of late recurrence after completion of tamoxifen for 5 years. Our results can be helpful in making decisions to use extended tamoxifen beyond 5 years.
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