Primary tamoxifen treatment for elderly women with operable breast cancer

In a series of 57 elderly women over 75 years old found to have an operable breast cancer tamoxifen 40 mg/day was administered as the initial treatment. In every instance of locally progressive disease the patients underwent a modified radical mastectomy and tamoxifen was administered at 20 mg/day. The time to change of management and the overall survival, were recorded. The follow up period of each patient was at least 5 years. The mean time to change of management was 22 months and by that time 47% of patients had passed from tamoxifen alone to surgery. The 5-year survival in the tamoxifen alone group was 50% while in the group with mastectomy 55,2%. Patients with positive estrogen receptors had a better outcome than the negative ones and the best ever response was 88,8% for ER positive and 15,4% for ER negative patients.