The ATLAS trial demonstrated improved survival for women with oestrogen receptor-positive breast cancer who continued taking tamoxifen for 10 years compared to stopping at 5 years. Women for whom absolute benefit outweighs adverse-effects should be selected based on their risk of recurrence beyond 5 years; support must be provided to maintain compliance.
Key Points
Women with oestrogen receptor-positive breast cancer who are relapse free 5 years after diagnosis might benefit from continuing tamoxifen to 10 years.
This is a preview of subscription content, access via your institution
Relevant articles
Open Access articles citing this article.
-
Refined protocols of tamoxifen injection for inducible DNA recombination in mouse astroglia
Scientific Reports Open Access 12 April 2018
Access options
Subscribe to this journal
Receive 12 print issues and online access
$209.00 per year
only $17.42 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
References
Davies, C. et al. Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years after diagnosis of oestrogen receptor-positive breast cancer: ATLAS, a randomised trial. Lancet http://dx.doi.org/10.1016/S0140-6736(12)61963-1.
Gray, R. G. et al. aTTom (adjuvant Tamoxifen--To offer more?): randomized trial of 10 versus 5 years of adjuvant tamoxifen among 6,934 women with estrogen receptor-positive (ER+) or ER untested breast cancer--Preliminary results [abstract]. J. Clin. Oncol. 26 (Suppl. 15), a513 (2008).
Seruga, B. & Tannock, I. F. Up-front use of aromatase inhibitors as adjuvant therapy for breast cancer: the emperor has no clothes. J. Clin. Oncol. 27, 840–842 (2009).
Dowsett, M. et al. Meta-analysis of breast cancer outcomes in adjuvant trials of aromatase inhibitors versus tamoxifen. J. Clin. Oncol. 28, 509–518 (2010).
Ruddy, K. J. & Partridge, A. H. Adherence with adjuvant hormonal therapy for breast cancer. Ann. Oncol. 20, 401–402 (2009).
Goss, P. E. et al. A randomized trial of letrozole in postmenopausal women after five years of tamoxifen therapy for early-stage breast cancer. N. Engl. J. Med. 349, 1793–1802 (2003).
Curtis, C. et al. The genomic and transcriptomic architecture of 2,000 breast tumours reveals novel subgroups. Nature 486, 395–399 (2012).
Dawson, S. J. et al. BCL2 in breast cancer: a favourable prognostic marker across molecular subtypes and independent of adjuvant therapy received. Br. J. Cancer 103, 668–675 (2010).
Ali, H. R. et al. A Ki67/BCL2 index based on immunohistochemistry is highly prognostic in ER-positive breast cancer. J. Pathol. 226, 97–107 (2012).
Amir, E., Seruga, B., Niraula, S., Carlsson, L. & Ocaña, A. Toxicity of adjuvant endocrine therapy in postmenopausal breast cancer patients: a systematic review and meta-analysis. J. Natl Cancer Inst. 103, 1299–1309 (2011).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no competing financial interests.
Rights and permissions
About this article
Cite this article
Caldas, C., Tannock, I. Tamoxifen—when more might be better. Nat Rev Clin Oncol 10, 125–126 (2013). https://doi.org/10.1038/nrclinonc.2013.17
Published:
Issue Date:
DOI: https://doi.org/10.1038/nrclinonc.2013.17
This article is cited by
-
Refined protocols of tamoxifen injection for inducible DNA recombination in mouse astroglia
Scientific Reports (2018)