A rationale for the reinitiation of adjuvant tamoxifen therapy in women receiving fewer than 5 years of therapy.

The overview analysis of adjuvant therapy trials in early-stage breast cancer by the Early Breast Cancer Trialists' Collaborative Group (EBCTCG) compared 1, 2, and 5 years of adjuvant therapy. The optimal benefit to patients in terms of reduced risk of recurrence and death was clearly conferred by 5 years of therapy with tamoxifen compared to shorter durations of therapy. Many women with early-stage breast cancer treated in the past received a recommendation for shorter durations of tamoxifen therapy. The obvious question is whether reinitiating tamoxifen to complete a full 5-year course would further reduce the risk of recurrence and death. In an attempt to explore this issue, we have analyzed recurrence rates in women who received different durations of tamoxifen therapy in the adjuvant setting. The data used for this analysis are directly from the EBCTCG. Our analysis suggests that women who received 1-2 years of adjuvant tamoxifen therapy may benefit from reinitiation of tamoxifen to complete a 5-year course.