Background: Tamoxifen's cost-benefit ratio for breast ductal intraepithelial neoplasia (DIN) is unclear. Since low-dose tamoxifen showed a favorable modulation of breast cancer biomarkers in phase II trials, a monoinstitutional cohort of women with DIN treated with low-dose tamoxifen or no systemic treatment was analyzed. Patients and methods: A total of 309 patients with DIN received low-dose tamoxifen as part of institutional guidelines and were compared with 371 patients with DIN who received no systemic treatment after surgery. Results: Women with estrogen receptor (ER)/progesterone receptor (PgR) >50% DIN who were not treated had a higher incidence of breast events than women on tamoxifen [hazard ratio (HR) 1.76; 95% confidence interval (CI) 1.00-3.12] or women with ER/PgR <50% DIN (HR 1.72; 95% CI 1.14-2.58). Among untreated patients with ER >50% DIN, recurrence was higher in PgR ≥50% DIN than in PgR <50% DIN, whereas it was similar among low PgR (<50%) DIN against which tamoxifen had no effect. No difference in endometrial cancer incidence was noted. Conclusions: High ER and especially high PgR expression is a significant adverse prognostic indicator of DIN, and low-dose tamoxifen appears to be an active treatment. Women with low-expression ER or PgR DIN do not seem to benefit from tamoxifen. A definitive clinical trial is warranted. © The Author 2009. Published by Oxford University Press.

Guerrieri Gonzaga, A., Botteri, E., Lazzeroni, M., Rotmensz, N., Goldhirsch, A., Varricchio, C., et al. (2010). Low-dose tamoxifen in the treatment of breast ductal intraepithelial neoplasia: results of a large observational study. ANNALS OF ONCOLOGY, 21(5), 949-954 [10.1093/annonc/mdp408].

Low-dose tamoxifen in the treatment of breast ductal intraepithelial neoplasia: results of a large observational study

BAGNARDI, VINCENZO;
2010

Abstract

Background: Tamoxifen's cost-benefit ratio for breast ductal intraepithelial neoplasia (DIN) is unclear. Since low-dose tamoxifen showed a favorable modulation of breast cancer biomarkers in phase II trials, a monoinstitutional cohort of women with DIN treated with low-dose tamoxifen or no systemic treatment was analyzed. Patients and methods: A total of 309 patients with DIN received low-dose tamoxifen as part of institutional guidelines and were compared with 371 patients with DIN who received no systemic treatment after surgery. Results: Women with estrogen receptor (ER)/progesterone receptor (PgR) >50% DIN who were not treated had a higher incidence of breast events than women on tamoxifen [hazard ratio (HR) 1.76; 95% confidence interval (CI) 1.00-3.12] or women with ER/PgR <50% DIN (HR 1.72; 95% CI 1.14-2.58). Among untreated patients with ER >50% DIN, recurrence was higher in PgR ≥50% DIN than in PgR <50% DIN, whereas it was similar among low PgR (<50%) DIN against which tamoxifen had no effect. No difference in endometrial cancer incidence was noted. Conclusions: High ER and especially high PgR expression is a significant adverse prognostic indicator of DIN, and low-dose tamoxifen appears to be an active treatment. Women with low-expression ER or PgR DIN do not seem to benefit from tamoxifen. A definitive clinical trial is warranted. © The Author 2009. Published by Oxford University Press.
Articolo in rivista - Articolo scientifico
breast cancer, DCIS, ductal intraepithelial neoplasia, low-dose tamoxifen
English
2010
21
5
949
954
none
Guerrieri Gonzaga, A., Botteri, E., Lazzeroni, M., Rotmensz, N., Goldhirsch, A., Varricchio, C., et al. (2010). Low-dose tamoxifen in the treatment of breast ductal intraepithelial neoplasia: results of a large observational study. ANNALS OF ONCOLOGY, 21(5), 949-954 [10.1093/annonc/mdp408].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/15669
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