HER2 Support Group Forums - View Single Post - Characteristics of recurrence after completing adjuvant tamoxifen therapy for 5 years

'lizbeth · 05-20-2014, 09:26 AM

Characteristics of recurrence after completing adjuvant tamoxifen therapy for 5 years: Retrospectove analysis

Abstract No:
e11507
Publication-only abstracts (abstract number preceded by an "e"), published in conjunction with the 2014 ASCO Annual Meeting but not presented at the Meeting, can be found online only.

Author(s): Eunshin Lee; Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea
Abstract Disclosures

Abstract:

Background: Treatment with tamoxifen (TMX) reduce the recurrence rate and increase overall survival in patients with hormone receptor positive breast cancer. Up to now, 5-year TMX therapy is generally accepted, but it is demonstrated that the rate of late recurrence after 5 years is considerably higher in hormone receptor positive type than in other subtype. Several clinical trials such as ATLAS and aTTom showed the benefit of continuing tamoxifen up to 10 years instead of stopping at 5 years without increasing mortality due to the effect of extended tamoxifen medication. Methods: We collected data of 1,633 hormone receptor positive breast cancer patients who received surgery at Seoul National University Hospital from 1997 to 2007, and had completed 5-year TMX therapy with no recurrence within 5 years after diagnosis. We excluded the cases treated aromatase inhibitor (AI) or switched to AI. Results: Among these patients, recurrence after 5 years of TMX therapy were found in 93 patients(late recurrence group). Local recurrence and distant metastasis were found in 43 and 50 patients, respectively. Electronic medical records were retrospectively reviewed for clinicopathological factors. When comparing between patients with no recurrence and patients with late recurrence, p53 and HER-2 expression were significantly related to late recurrence (p=0.01, p<0.001 respectively). Also when subgroup analysis was done for distant metastasis of late recurrence group, distant metastasis was significantly associated with HER-2 expression and high nuclear grade (p=0.005, p=0.006 respectively). There are no relation between late recurrence and age, stage and ki-67. Conclusions: our data shows that p53 and HER-2 expression is associated to late recurrence and especially HER-2 expression is related to distant metastasis after completing TMX for 5 years. On the basis of the result of large clinical trials, extending TMX therapy significantly reduces recurrence rate and increase survival. Our result support continuing TMX in patients with HER-2 expression and high nuclear grade is considerable after 5 years of TMX medication.

05-20-2014, 09:26 AM	#1
'lizbeth Senior Member Join Date: Apr 2008 Location: Sunny San Diego Posts: 2,214	Characteristics of recurrence after completing adjuvant tamoxifen therapy for 5 years Characteristics of recurrence after completing adjuvant tamoxifen therapy for 5 years: Retrospectove analysis Abstract No: e11507 Publication-only abstracts (abstract number preceded by an "e"), published in conjunction with the 2014 ASCO Annual Meeting but not presented at the Meeting, can be found online only. Author(s): Eunshin Lee; Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea Abstract Disclosures Abstract: Background: Treatment with tamoxifen (TMX) reduce the recurrence rate and increase overall survival in patients with hormone receptor positive breast cancer. Up to now, 5-year TMX therapy is generally accepted, but it is demonstrated that the rate of late recurrence after 5 years is considerably higher in hormone receptor positive type than in other subtype. Several clinical trials such as ATLAS and aTTom showed the benefit of continuing tamoxifen up to 10 years instead of stopping at 5 years without increasing mortality due to the effect of extended tamoxifen medication. Methods: We collected data of 1,633 hormone receptor positive breast cancer patients who received surgery at Seoul National University Hospital from 1997 to 2007, and had completed 5-year TMX therapy with no recurrence within 5 years after diagnosis. We excluded the cases treated aromatase inhibitor (AI) or switched to AI. Results: Among these patients, recurrence after 5 years of TMX therapy were found in 93 patients(late recurrence group). Local recurrence and distant metastasis were found in 43 and 50 patients, respectively. Electronic medical records were retrospectively reviewed for clinicopathological factors. When comparing between patients with no recurrence and patients with late recurrence, p53 and HER-2 expression were significantly related to late recurrence (p=0.01, p<0.001 respectively). Also when subgroup analysis was done for distant metastasis of late recurrence group, distant metastasis was significantly associated with HER-2 expression and high nuclear grade (p=0.005, p=0.006 respectively). There are no relation between late recurrence and age, stage and ki-67. Conclusions: our data shows that p53 and HER-2 expression is associated to late recurrence and especially HER-2 expression is related to distant metastasis after completing TMX for 5 years. On the basis of the result of large clinical trials, extending TMX therapy significantly reduces recurrence rate and increase survival. Our result support continuing TMX in patients with HER-2 expression and high nuclear grade is considerable after 5 years of TMX medication.