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Among postmenopausal women with estrogen receptor-positive breast cancer and between one and three positive lymph nodes, adjuvant treatment with chemotherapy and tamoxifen resulted in longer survival without cancer recurrence than adjuvant treatment with tamoxifen alone. These results were published in the Annals of Oncology.

Each year, breast cancer is diagnosed in over 200,000 women in the U.S. alone. Many of these breast cancers will be hormone receptor-positive, meaning that they are stimulated to grow by the circulating female hormones estrogen and/or progesterone.

Treatment of hormone receptor-positive breast cancer often involves hormonal therapies that suppress or block the action of estrogen. These therapies include tamoxifen as well as agents known as aromatase inhibitors. Researchers have worked to define the additional benefit of chemotherapy among postmenopausal women who are candidates for hormonal therapy.

To compare survival after adjuvant therapy with chemotherapy and tamoxifen to survival after adjuvant therapy with tamoxifen alone, researchers in France analyzed data from two clinical trials. A total of 457 postmenopausal women with early breast cancer received tamoxifen alone (30 mg per day for three years) or FEC50 chemotherapy (fluorouracil, epirubicin, and cyclophosphamide every three weeks for six cycles) plus tamoxifen. Patients were also treated with radiation therapy. All women had estrogen receptor-positive breast cancer and between one and three involved lymph nodes.

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After nine years of follow-up, treatment with FEC50 plus tamoxifen showed superior results: 84% of the women treated with FEC50 plus tamoxifen were alive and recurrence-free, compared to 72% of the women treated with tamoxifen alone. Overall survival was 86% in the women treated with FEC50 plus tamoxifen and 78% in the women treated with tamoxifen alone.

The researchers concluded that the addition of FEC50 chemotherapy to tamoxifen resulted in longer survival without cancer recurrence in postmenopausal women with estrogen receptor-positive breast cancer and between one and three positive lymph nodes.

Reference: Namer M, Fargeot P, Roché H et al. Improved Disease-Free Survival with Epirubicin-Based Chemoendocrine Adjuvant Therapy Compared With Tamoxifen Alone in One to Three Node-Positive, Estrogen-Receptor-Positive, Postmenopausal Breast Cancer Patients: Results of French Adjuvant Study group 02 and 07 Trials. Annals of Oncology. 2006;17:65-73.