Prospective randomized trial of tamoxifen vs surgery in elderly patients with breast cancer

Between 1982 and 1989, 200 patients aged 70 or over seen in one Breast Unit, who were considered to have a surgically resectable cancer of the breast were prospectively randomized to primary surgery or tamoxifen 20 mg per day. At a median follow-up of 6 years (range 3-11 years) and at the censoring data there were 61 first events in the tamoxifen group. Fifty three patients developed local relapse or progression of the cancer; three patients had simulatenous local progression or relapse and distant metastases. In addition a further five patients developed distant recurrence only. In the surgical arm there were 50 events. Thirty-six patients developed local recurrence only; eight had simultaneous local progression or relapse and distant metastases