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document
Pathology parameters and adjuvant tamoxifen response in a randomised premenopausal breast cancer trial . BACKGROUND Subgroups of breast cancer that have an impaired response to endocrine treatment , despite hormone receptor positivity , are still poorly defined . Breast cancer can be subdivided according to standard pathological parameters including histological type , grade , and assessment of proliferation . These parameters are the net result of combinations of genetic alterations effecting tumour behaviour and could potentially reflect subtypes that respond differently to endocrine treatment . AIMS To investigate the usefulness of these parameters as predictors of the response to tamoxifen in premenopausal women with breast cancer . MATERIALS/METHODS Clinically established pathological parameters were assessed and related to the tamoxifen response in 500 available tumour specimens from 564 premenopausal patients with breast cancer randomised to either two years of tamoxifen or no treatment with 14 years of follow up . Proliferation was further evaluated by immunohistochemical Ki-67 expression . RESULTS Oestrogen receptor positive ductal carcinomas responded as expected to tamoxifen , whereas the difference in recurrence free survival between control and tamoxifen treated patients was less apparent in the relatively few lobular carcinomas . For histological grade , there was no obvious difference in treatment response between the groups . The relation between proliferation and tamoxifen response seemed to be more complex , with a clear response in tumours with high and low proliferation , whereas tumours with intermediate proliferation defined by Ki-67 responded more poorly . CONCLUSIONS Clinically established pathology parameters seem to mirror the endocrine treatment response and could potentially be valuable in future treatment decisions for patients with breast cancer .
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Intervention_Pharmacological
tamoxifen
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Intervention_Pharmacological
tamoxifen
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Intervention_Pharmacological
tamoxifen
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Intervention_Pharmacological
tamoxifen
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Intervention_Control
no treatment
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Intervention_Pharmacological
tamoxifen
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Intervention_Control
control
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Intervention_Pharmacological
tamoxifen
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Intervention_Pharmacological
tamoxifen
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Outcome_Physical
adjuvant tamoxifen response
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Outcome_Physical
Oestrogen receptor positive ductal carcinomas
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Outcome_Mortality
recurrence free survival
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Outcome_Physical
more complex , with a clear response in tumours with high and low proliferation
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Outcome_Other
poorly
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Participant_Condition
premenopausal breast cancer
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Participant_Condition
premenopausal
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Participant_Sex
women
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Participant_Condition
breast cancer
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Participant_Sample-size
500
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Participant_Sample-size
564
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Participant_Condition
patients with breast cancer