Discussion
recurrence/death, ER-positive BC [In this reanalysis, ER-positive
RECURRENCE
Tamoxifen is a common and established adjuvant therapy, particularly for premenopausal patients with ER-positive BC [In this reanalysis of a large randomized trial of women with ER-positive BC, at a median follow-up of more than 8 years, and after adjustment for treatment adherence, the patients in the extended therapy group (12 years) had a significantly improved iDFS and OS than those who received ST therapy (2–3 years) (iDFS HR of 0.55 (0.48–0.64) and of 0.79 (0.67–0.95); OS HR of 0.70 (0.59–0.83) and of 0.85 (0.64–1.04) using MSMs and RPSFTM, respectively). These estimates indicated a significantly larger treatment effect with respect to ITT analysis.This analysis is still significantly relevant, provided that adjuvant endocrine therapy for 5 years or longer remains a cornerstone in the treatment of patients with HR + BC.The Adjuvant Tamoxifen, To Offer More? (aTTom [To our knowledge, the treatment benefits for survival have not been estimated in any of the previous published studies investigating extended tamoxifen, adjusting for adherence. Colleoni et al. [Some important issues need to be addressed: nowadays, tamoxifen 20 mg/day for 5 years is still considered the standard of care to reduce the risk of recurrence/death in premenopausal women with ER-positive BC who are at low risk of recurrence [In future research, we plan to complement the current analysis using the contemporary CANTO cohort [