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Recurrence-free survival in breast cancer improved by adjuvant tamoxifen--especially for progesterone receptor positive tumors with a high proliferation

Fernö, Mårten LU ; Baldetorp, Bo LU ; Bendahl, Pär-Ola LU ; Borg, Åke LU ; Ewers, Sven-Börje LU ; Olsson, Håkan LU ; Ryden, Stefan; Sigurdsson, Helgi and Killander, Dick LU (1995) In Breast Cancer Research and Treatment 36(1). p.23-34
Abstract
Although the beneficial effect on breast cancer of adjuvant tamoxifen (TAM) is well established, in the series studied by our group this effect seems to have been restricted to patients with steroid receptor (especially progesterone receptor (PgR)) positive tumors. However, as some patients with PgR-positive tumors manifested recurrence despite adjuvant TAM treatment, the question arose whether some other biological factor(s) could be used to identify these non-responding cases. The level of the S-phase fraction (SPF), as measured by flow cytometry, has been shown to be a useful prognostic marker, prognosis being better in cases where the SPF is low than in those where it is high. The aim of the present study was to relate the prognosis... (More)
Although the beneficial effect on breast cancer of adjuvant tamoxifen (TAM) is well established, in the series studied by our group this effect seems to have been restricted to patients with steroid receptor (especially progesterone receptor (PgR)) positive tumors. However, as some patients with PgR-positive tumors manifested recurrence despite adjuvant TAM treatment, the question arose whether some other biological factor(s) could be used to identify these non-responding cases. The level of the S-phase fraction (SPF), as measured by flow cytometry, has been shown to be a useful prognostic marker, prognosis being better in cases where the SPF is low than in those where it is high. The aim of the present study was to relate the prognosis after adjuvant TAM to SPF among patients with PgR-positive tumors. In the PgR-positive group as a whole, the effect of TAM on prognosis was more pronounced in the high SPF group than in the low SPF group (p = 0.005) the respective decrease in 3 year recurrence rate was from 19 to 43% and from 17 to 9%. Multivariate analysis of the data for the TAM-treated group showed the level of PgR concentration (low positive vs. high positive), lymph node status, and tumor size to be independent predictive factors, but not the level of SPF (i.e. high vs. low). By contrast, among patients not treated with TAM, the SPF was a strong independent prognostic factor. To sum up, SPF was a strong independent predictor of outcome only for patients receiving no systemic adjuvant therapy, but not in patients receiving adjuvant TAM. Patients with PgR-positive and high S-phase tumors derived more benefit from TAM than patients with PgR-positive and low SPF tumors. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
breast cancer, flow cytometry, progesterone receptor, prognosis, proliferation, treatment prediction
in
Breast Cancer Research and Treatment
volume
36
issue
1
pages
23 - 34
publisher
Springer
external identifiers
  • pmid:7579503
  • scopus:0029042672
ISSN
1573-7217
DOI
10.1007/BF00690181
language
English
LU publication?
yes
id
789b4c4e-d85d-4f70-b779-d6f51b02cc36 (old id 1108879)
date added to LUP
2008-07-25 08:36:41
date last changed
2017-01-08 04:54:56
@article{789b4c4e-d85d-4f70-b779-d6f51b02cc36,
  abstract     = {Although the beneficial effect on breast cancer of adjuvant tamoxifen (TAM) is well established, in the series studied by our group this effect seems to have been restricted to patients with steroid receptor (especially progesterone receptor (PgR)) positive tumors. However, as some patients with PgR-positive tumors manifested recurrence despite adjuvant TAM treatment, the question arose whether some other biological factor(s) could be used to identify these non-responding cases. The level of the S-phase fraction (SPF), as measured by flow cytometry, has been shown to be a useful prognostic marker, prognosis being better in cases where the SPF is low than in those where it is high. The aim of the present study was to relate the prognosis after adjuvant TAM to SPF among patients with PgR-positive tumors. In the PgR-positive group as a whole, the effect of TAM on prognosis was more pronounced in the high SPF group than in the low SPF group (p = 0.005) the respective decrease in 3 year recurrence rate was from 19 to 43% and from 17 to 9%. Multivariate analysis of the data for the TAM-treated group showed the level of PgR concentration (low positive vs. high positive), lymph node status, and tumor size to be independent predictive factors, but not the level of SPF (i.e. high vs. low). By contrast, among patients not treated with TAM, the SPF was a strong independent prognostic factor. To sum up, SPF was a strong independent predictor of outcome only for patients receiving no systemic adjuvant therapy, but not in patients receiving adjuvant TAM. Patients with PgR-positive and high S-phase tumors derived more benefit from TAM than patients with PgR-positive and low SPF tumors.},
  author       = {Fernö, Mårten and Baldetorp, Bo and Bendahl, Pär-Ola and Borg, Åke and Ewers, Sven-Börje and Olsson, Håkan and Ryden, Stefan and Sigurdsson, Helgi and Killander, Dick},
  issn         = {1573-7217},
  keyword      = {breast cancer,flow cytometry,progesterone receptor,prognosis,proliferation,treatment prediction},
  language     = {eng},
  number       = {1},
  pages        = {23--34},
  publisher    = {Springer},
  series       = {Breast Cancer Research and Treatment},
  title        = {Recurrence-free survival in breast cancer improved by adjuvant tamoxifen--especially for progesterone receptor positive tumors with a high proliferation},
  url          = {http://dx.doi.org/10.1007/BF00690181},
  volume       = {36},
  year         = {1995},
}