Hughes, KevinSchnaper, LaurenBellon, JenniferCirrincione, ConstanceBerry, DonaldMcCormick, BerylMuss, HymanSmith, BarbaraHudis, Clifford2020-05-122013Hughes, Kevin S, Lauren A Schnaper, Jennifer R Bellon, Constance T Cirrincione, Donald A Berry, Beryl Mccormick, Hyman B Muss, Barbara L Smith, Clifford A Hudis, Eric P Winer, and William C Wood. 2013. Lumpectomy Plus Tamoxifen With or Without Irradiation in Women Age 70 Years or Older With Early Breast Cancer: Long-Term Follow-Up of CALGB 9343. Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology 31, no. 19: 2382-7.0732-183X1527-7755http://nrs.harvard.edu/urn-3:HUL.InstRepos:42665432Purpose: To determine whether there is a benefit to adjuvant radiation therapy after breast-conserving surgery and tamoxifen in women age 70 years with early-stage breast cancer. Patients and Methods: Between July 1994 and February 1999, 636 women (age 70 years) who had clinical stage I (T1N0M0 according to TNM classification) estrogen receptor (ER) –positive breast carcinoma treated by lumpectomy were randomly assigned to receive tamoxifen plus radiation therapy (TamRT; 317 women) or tamoxifen alone (Tam; 319 women). Primary end points were time to local or regional recurrence, frequency of mastectomy, breast cancer–specific survival, time to distant metastasis, and overall survival (OS). Results: Median follow-up for treated patients is now 12.6 years. At 10 years, 98% of patients receiving TamRT (95% CI, 96% to 99%) compared with 90% of those receiving Tam (95% CI, 85% to 93%) were free from local and regional recurrences. There were no significant differences in time to mastectomy, time to distant metastasis, breast cancer–specific survival, or OS between the two groups. Ten-year OS was 67% (95% CI, 62% to 72%) and 66% (95% CI, 61% to 71%) in the TamRT and Tam groups, respectively. Conclusion: With long-term follow-up, the previously observed small improvement in locoregional recurrence with the addition of radiation therapy remains. However, this does not translate into an advantage in OS, distant disease-free survival, or breast preservation. Depending on the value placed on local recurrence, Tam remains a reasonable option for women age 70 years with ER-positive early-stage breast cancer.en-USJournal Article2018-03-3120132020-05-1210.1200/JCO.2012.45.2615