All patients received Tamoxifen 10mg twice a day for five years and Tamoxifen with chemotherapy were begun within five weeks after surgery. Radiation was given to patients who chose lumpectomy and desired to preserve their breast. Radiation was given after the first cycle of chemotherapy in general. The authors found that women who received chemotherapy and Tamoxifen did better. The authors also looked at survival and found that survival was better in the women who received Tamoxifen and chemotherapy than Tamoxifen alone.
Many women inquire whether treatments can induce cancers.
In fact, chemotherapy reduced rates of recurrences in both groups. Also, chemo-therapeutic treatments seemed to benefit patients regardless of the amount of elevation or presence of the estrogen receptor in the cancer. There was an advantage in giving chemotherapy both to women under age 50 as well as over age 50 but the benefit was greater in the younger group. In this study statistical analysis did not show a group of patients who did not benefit from chemotherapy with hormonal approach. Further work will be ongoing in women with very small tumors measuring less than 1cm to further determine the benefit or need for chemotherapy in that group.