Journal Article
. 2010 Jun;362(22).
doi: 10.1056/NEJMoa0909638.

Longer therapy, iatrogenic amenorrhea, and survival in early breast cancer

Sandra M Swain 1 Jong-Hyeon Jeong  Charles E Geyer  Joseph P Costantino  Eduardo R Pajon  Louis Fehrenbacher  James N Atkins  Jonathan Polikoff  Victor G Vogel  John K Erban  Priya Rastogi  Robert B Livingston  Edith A Perez  Eleftherios P Mamounas  Stephanie R Land  Patricia A Ganz  Norman Wolmark  
Affiliations
  • PMID: 20519679
  •     13 References
  •     82 citations

Abstract

Background: Chemotherapy regimens that combine anthracyclines and taxanes result in improved disease-free and overall survival among women with operable lymph-node-positive breast cancer. The effectiveness of concurrent versus sequential regimens is not known.

Methods: We randomly assigned 5351 patients with operable, node-positive, early-stage breast cancer to receive four cycles of doxorubicin and cyclophosphamide followed by four cycles of docetaxel (sequential ACT); four cycles of doxorubicin and docetaxel (doxorubicin-docetaxel); or four cycles of doxorubicin, cyclophosphamide, and docetaxel (concurrent ACT). The primary aims were to examine whether concurrent ACT was more effective than sequential ACT and whether the doxorubicin-docetaxel regimen would be as effective as the concurrent-ACT regimen. The secondary aims were to assess toxic effects and to correlate amenorrhea with outcomes in premenopausal women.

Results: At a median follow-up of 73 months, overall survival was improved in the sequential-ACT group (8-year overall survival, 83%) as compared with the doxorubicin-docetaxel group (overall survival, 79%; hazard ratio for death, 0.83; P=0.03) and the concurrent-ACT group (overall survival, 79%; hazard ratio, 0.86; P=0.09). Disease-free survival was improved in the sequential-ACT group (8-year disease-free survival, 74%) as compared with the doxorubicin-docetaxel group (disease-free survival, 69%; hazard ratio for recurrence, a second malignant condition, or death, 0.80; P=0.001) and the concurrent-ACT group (disease-free survival, 69%; hazard ratio, 0.83; P=0.01). The doxorubicin-docetaxel regimen showed noninferiority to the concurrent-ACT regimen for overall survival (hazard ratio, 0.96; 95% confidence interval, 0.82 to 1.14). Overall survival was improved in patients with amenorrhea for 6 months or more across all treatment groups, independently of estrogen-receptor status.

Conclusions: Sequential ACT improved disease-free survival as compared with doxorubicin-docetaxel or concurrent ACT, and it improved overall survival as compared with doxorubicin-docetaxel. Amenorrhea was associated with improved survival regardless of the treatment and estrogen-receptor status. (ClinicalTrials.gov number, NCT00003782.)

Docetaxel and doxorubicin compared with doxorubicin and cyclophosphamide as first-line chemotherapy for metastatic breast cancer: results of a randomized, multicenter, phase III trial.
Jean-Marc Nabholtz, Carla Falkson, +15 authors, TAX 306 Study Group.
J Clin Oncol, 2003 Mar 15; 21(6). PMID: 12637459
Improved outcomes from adding sequential Paclitaxel but not from escalating Doxorubicin dose in an adjuvant chemotherapy regimen for patients with node-positive primary breast cancer.
I Craig Henderson, Donald A Berry, +16 authors, Larry Norton.
J Clin Oncol, 2003 Mar 15; 21(6). PMID: 12637460
Highly Cited.
Amenorrhea in premenopausal women on the doxorubicin-and-cyclophosphamide-followed-by-docetaxel arm of NSABP B-30 trial.
Sandra M Swain, Stephanie R Land, +5 authors, Patricia A Ganz.
Breast Cancer Res Treat, 2008 Feb 28; 113(2). PMID: 18302020    Free PMC article.
Residual risk of breast cancer recurrence 5 years after adjuvant therapy.
Abenaa M Brewster, Gabriel N Hortobagyi, +8 authors, Francisco J Esteva.
J Natl Cancer Inst, 2008 Aug 13; 100(16). PMID: 18695137    Free PMC article.
Highly Cited.
Adjuvant chemotherapy followed by goserelin versus either modality alone for premenopausal lymph node-negative breast cancer: a randomized trial.
International Breast Cancer Study Group (IBCSG), Monica Castiglione-Gertsch, +7 authors, Richard D Gelber.
J Natl Cancer Inst, 2003 Dec 18; 95(24). PMID: 14679153
Designs for group sequential tests.
T R Fleming, D P Harrington, P C O'Brien.
Control Clin Trials, 1984 Dec 01; 5(4). PMID: 6518769
Dose and dose intensity as determinants of outcome in the adjuvant treatment of breast cancer. The Cancer and Leukemia Group B.
D R Budman, D A Berry, +8 authors, E Frei.
J Natl Cancer Inst, 1998 Aug 27; 90(16). PMID: 9719081
Highly Cited.
Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials.
Early Breast Cancer Trialists' Collaborative Group (EBCTCG).
Lancet, 2005 May 17; 365(9472). PMID: 15894097
Highly Cited.
Chemoendocrine therapy for premenopausal women with axillary lymph node-positive, steroid hormone receptor-positive breast cancer: results from INT 0101 (E5188).
Nancy E Davidson, Anne M O'Neill, +4 authors, Martin D Abeloff.
J Clin Oncol, 2005 Aug 10; 23(25). PMID: 16087950
The influence of endocrine effects of adjuvant therapy on quality of life outcomes in younger breast cancer survivors.
M Tish Knobf.
Oncologist, 2006 Feb 16; 11(2). PMID: 16476831
Review.
Phase III trial comparing three doses of docetaxel for second-line treatment of advanced breast cancer.
Vernon Harvey, Henning Mouridsen, +6 authors, Soeren Cold.
J Clin Oncol, 2006 Oct 13; 24(31). PMID: 17033039
Amenorrhea in premenopausal women after adjuvant chemotherapy for breast cancer.
Janice M Walshe, Neelima Denduluri, Sandra M Swain.
J Clin Oncol, 2006 Nov 30; 24(36). PMID: 17130515
Review.
Use of luteinising-hormone-releasing hormone agonists as adjuvant treatment in premenopausal patients with hormone-receptor-positive breast cancer: a meta-analysis of individual patient data from randomised adjuvant trials.
LHRH-agonists in Early Breast Cancer Overview group, J Cuzick, +5 authors, R Sainsbury.
Lancet, 2007 May 22; 369(9574). PMID: 17512856
Breast cancer in young women.
Courtney A Gabriel, Susan M Domchek.
Breast Cancer Res, 2010 Nov 12; 12(5). PMID: 21067532    Free PMC article.
Review.
Menstrual history and quality-of-life outcomes in women with node-positive breast cancer treated with adjuvant therapy on the NSABP B-30 trial.
Patricia A Ganz, Stephanie R Land, +13 authors, Sandra M Swain.
J Clin Oncol, 2011 Feb 09; 29(9). PMID: 21300930    Free PMC article.
Long-term results of International Breast Cancer Study Group Trial VIII: adjuvant chemotherapy plus goserelin compared with either therapy alone for premenopausal patients with node-negative breast cancer.
P Karlsson, Z Sun, +14 authors, A Goldhirsch.
Ann Oncol, 2011 Feb 18; 22(10). PMID: 21325445    Free PMC article.
Strategies for subtypes--dealing with the diversity of breast cancer: highlights of the St. Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2011.
A Goldhirsch, W C Wood, +4 authors, Panel members.
Ann Oncol, 2011 Jun 29; 22(8). PMID: 21709140    Free PMC article.
Highly Cited.
Concurrent vs sequential adjuvant chemotherapy and hormone therapy in breast cancer: a multicenter randomized phase III trial.
Davide Bedognetti, Mario Roberto Sertoli, +12 authors, Paolo Bruzzi.
J Natl Cancer Inst, 2011 Sep 17; 103(20). PMID: 21921285    Free PMC article.
Reproductive endocrinology: triptorelin ovarian suppression during breast cancer chemotherapy.
Elizabeth S Ginsburg, Ann H Partridge.
Nat Rev Endocrinol, 2011 Sep 21; 7(11). PMID: 21931373
Randomized trial using gonadotropin-releasing hormone agonist triptorelin for the preservation of ovarian function during (neo)adjuvant chemotherapy for breast cancer.
Pamela N Munster, Amy P Moore, +6 authors, Susan E Minton.
J Clin Oncol, 2012 Jan 11; 30(5). PMID: 22231041    Free PMC article.
Poor-prognosis estrogen receptor- positive disease: present and future clinical solutions.
Per E Lønning.
Ther Adv Med Oncol, 2012 May 17; 4(3). PMID: 22590486    Free PMC article.
Extended benefit from sequential administration of docetaxel after standard fluorouracil, epirubicin, and cyclophosphamide regimen for node-positive breast cancer: the 8-year follow-up results of the UNICANCER-PACS01 trial.
Bruno Coudert, Bernard Asselain, +18 authors, UNICANCER Breast Group.
Oncologist, 2012 May 23; 17(7). PMID: 22610153    Free PMC article.
The risk of amenorrhea is related to chemotherapy-induced leucopenia in breast cancer patients receiving epirubicin and taxane based chemotherapy.
Wenbin Zhou, Qiang Ding, +4 authors, Shui Wang.
PLoS One, 2012 May 23; 7(5). PMID: 22615953    Free PMC article.
NC-6301, a polymeric micelle rationally optimized for effective release of docetaxel, is potent but is less toxic than native docetaxel in vivo.
Mitsunori Harada, Caname Iwata, +7 authors, Mitsunobu R Kano.
Int J Nanomedicine, 2012 Jun 30; 7. PMID: 22745540    Free PMC article.
Six cycles of doxorubicin and cyclophosphamide or Paclitaxel are not superior to four cycles as adjuvant chemotherapy for breast cancer in women with zero to three positive axillary nodes: Cancer and Leukemia Group B 40101.
Lawrence N Shulman, Constance T Cirrincione, +12 authors, Clifford Hudis.
J Clin Oncol, 2012 Jul 25; 30(33). PMID: 22826271    Free PMC article.
Chemotherapy-induced ovarian failure as a prototype for acute vascular toxicity.
Irit Ben-Aharon, Israel Meizner, +6 authors, Salomon M Stemmer.
Oncologist, 2012 Sep 08; 17(11). PMID: 22956534    Free PMC article.
Impact of premenopausal status at breast cancer diagnosis in women entered on the placebo-controlled NCIC CTG MA17 trial of extended adjuvant letrozole.
P E Goss, J N Ingle, +11 authors, D Tu.
Ann Oncol, 2012 Oct 03; 24(2). PMID: 23028039    Free PMC article.
PAM50 breast cancer subtyping by RT-qPCR and concordance with standard clinical molecular markers.
Roy R L Bastien, Álvaro Rodríguez-Lescure, +29 authors, Miguel Martín.
BMC Med Genomics, 2012 Oct 06; 5. PMID: 23035882    Free PMC article.
Highly Cited.
Vascular endothelial growth factor expression and T-regulatory cells in premenopausal breast cancer.
Francesco Recchia, Giampiero Candeloro, +4 authors, Silvio Rea.
Oncol Lett, 2013 Apr 20; 5(4). PMID: 23599749    Free PMC article.
Docetaxel-induced skin toxicities in breast cancer patients subsequent to paclitaxel shortage: a case series and literature review.
Ming J Poi, Michael Berger, +6 authors, Robert Wesolowski.
Support Care Cancer, 2013 May 21; 21(10). PMID: 23686402    Free PMC article.
Oophorectomy in breast cancer-controversies and current status.
Gurpreet Singh.
Indian J Surg, 2013 Jun 05; 74(3). PMID: 23730045    Free PMC article.
Chemotherapy-induced amenorrhea: a prospective study of brain activation changes and neurocognitive correlates.
Susan K Conroy, Brenna C McDonald, +2 authors, Andrew J Saykin.
Brain Imaging Behav, 2013 Jun 25; 7(4). PMID: 23793983    Free PMC article.
A link between premenopausal iron deficiency and breast cancer malignancy.
Jinlong Jian, Qing Yang, +8 authors, Xi Huang.
BMC Cancer, 2013 Jun 27; 13. PMID: 23800380    Free PMC article.
Hormonal therapies in young breast cancer patients: when, what and for how long?
Alexandre Christinat, Simona Di Lascio, Olivia Pagani.
J Thorac Dis, 2013 Jul 03; 5 Suppl 1. PMID: 23819026    Free PMC article.
Treatment of breast cancer in young women: do we need more aggressive therapies?
Giuseppe Cancello, Emilia Montagna.
J Thorac Dis, 2013 Jul 03; 5 Suppl 1. PMID: 23819027    Free PMC article.
Fertility counseling of young breast cancer patients.
Matteo Lambertini, Paola Anserini, +2 authors, Lucia Del Mastro.
J Thorac Dis, 2013 Jul 03; 5 Suppl 1. PMID: 23819030    Free PMC article.
Challenges of guarantee-time bias.
Anita Giobbie-Hurder, Richard D Gelber, Meredith M Regan.
J Clin Oncol, 2013 Jul 10; 31(23). PMID: 23835712    Free PMC article.
Highly Cited.
Definitive results of a phase III adjuvant trial comparing three chemotherapy regimens in women with operable, node-positive breast cancer: the NSABP B-38 trial.
Sandra M Swain, Gong Tang, +17 authors, Norman Wolmark.
J Clin Oncol, 2013 Aug 14; 31(26). PMID: 23940225    Free PMC article.
Pretreatment anti-Müllerian hormone predicts for loss of ovarian function after chemotherapy for early breast cancer.
Richard A Anderson, Mikkel Rosendahl, Thomas W Kelsey, David A Cameron.
Eur J Cancer, 2013 Aug 24; 49(16). PMID: 23968732    Free PMC article.
Biomarker prediction of chemotherapy-related amenorrhea in premenopausal women with breast cancer participating in E5103.
Kathryn J Ruddy, Anne O'Neill, +7 authors, Ann H Partridge.
Breast Cancer Res Treat, 2014 Mar 04; 144(3). PMID: 24584876    Free PMC article.
Incidence of chemotherapy-induced ovarian failure in premenopausal women undergoing chemotherapy for breast cancer.
V Tiong, A M Rozita, +2 authors, C H Ng.
World J Surg, 2014 Apr 05; 38(9). PMID: 24700093
Coprescription of Chinese herbal medicine and Western medication among female patients with breast cancer in Taiwan: analysis of national insurance claims.
Bih-Ru Wang, Yuh-Lih Chang, +5 authors, Yueh-Ching Chou.
Patient Prefer Adherence, 2014 May 24; 8. PMID: 24855343    Free PMC article.
Changes in ovarian function in premenopausal women with breast cancer undergoing adjuvant TC (docetaxel and cyclophosphamide) chemotherapy during a brief period of amenorrhea around the last chemotherapy cycle.
Keiko Yoshimura, Yoshihiko Furuya.
Springerplus, 2014 Aug 01; 3. PMID: 25077063    Free PMC article.
Breast cancer in young women: special considerations in multidisciplinary care.
Chantal Reyna, Marie Catherine Lee.
J Multidiscip Healthc, 2014 Oct 11; 7. PMID: 25300196    Free PMC article.
Review.
Update on adjuvant chemotherapy for early breast cancer.
Murtuza M Rampurwala, Gabrielle B Rocque, Mark E Burkard.
Breast Cancer (Auckl), 2014 Oct 23; 8. PMID: 25336961    Free PMC article.
Review.
Goserelin for ovarian protection during breast-cancer adjuvant chemotherapy.
Halle C F Moore, Joseph M Unger, +22 authors, POEMS/S0230 Investigators.
N Engl J Med, 2015 Mar 05; 372(10). PMID: 25738668    Free PMC article.
Highly Cited.
Elevated risks of subsequent endometrial cancer development among breast cancer survivors with different hormone receptor status: a SEER analysis.
Jieqiong Liu, Wen Jiang, +5 authors, Lisa K Jacobs.
Breast Cancer Res Treat, 2015 Mar 13; 150(2). PMID: 25764167    Free PMC article.
Adjuvant chemotherapy for early female breast cancer: a systematic review of the evidence for the 2014 Cancer Care Ontario systemic therapy guideline.
S Gandhi, G G Fletcher, +4 authors, M E Trudeau.
Curr Oncol, 2015 Apr 08; 22(Suppl 1). PMID: 25848343    Free PMC article.
Review.
Breast cancer in young women in southern Tunisia: Anatomical study and clinical prognostic factors: About a series of 83 patients.
Mouna Kallel, Fatma Elloumi, +5 authors, Jamel Daoud.
Rep Pract Oncol Radiother, 2015 May 08; 20(3). PMID: 25949218    Free PMC article.
Review.
Chemotherapy-related amenorrhea after adjuvant paclitaxel-trastuzumab (APT trial).
Kathryn J Ruddy, Hao Guo, +17 authors, Sara M Tolaney.
Breast Cancer Res Treat, 2015 May 20; 151(3). PMID: 25981899    Free PMC article.
Adjuvant Metronomic CMF in a Contemporary Breast Cancer Cohort: What's Old Is New.
Eunpi Cho, Ann K Schwemm, +7 authors, Vijayakrishna K Gadi.
Clin Breast Cancer, 2015 May 31; 15(5). PMID: 26025883    Free PMC article.
Progress in adjuvant chemotherapy for breast cancer: an overview.
Jesus Anampa, Della Makower, Joseph A Sparano.
BMC Med, 2015 Aug 19; 13. PMID: 26278220    Free PMC article.
Highly Cited. Review.
Impact of biomarker changes during neoadjuvant chemotherapy for clinical response in patients with residual breast cancers.
Yukie Enomoto, Takashi Morimoto, +11 authors, Yasuo Miyoshi.
Int J Clin Oncol, 2015 Sep 05; 21(2). PMID: 26338270
Gonadotropin-Releasing Hormone Agonists for Ovarian Function Preservation in Premenopausal Women Undergoing Chemotherapy for Early-Stage Breast Cancer: A Systematic Review and Meta-analysis.
Rodrigo R Munhoz, Allan A L Pereira, +4 authors, Ricardo J Marques.
JAMA Oncol, 2015 Oct 02; 2(1). PMID: 26426573    Free PMC article.
Systematic Review.
Time-Varying Effects of Breast Cancer Adjuvant Systemic Therapy.
Ismail Jatoi, Hanna Bandos, +4 authors, Norman Wolmark.
J Natl Cancer Inst, 2015 Nov 01; 108(1). PMID: 26518884    Free PMC article.
Body Mass Index at Diagnosis and Breast Cancer Survival Prognosis in Clinical Trial Populations from NRG Oncology/NSABP B-30, B-31, B-34, and B-38.
Reena S Cecchini, Sandra M Swain, +9 authors, Norman Wolmark.
Cancer Epidemiol Biomarkers Prev, 2015 Nov 08; 25(1). PMID: 26545405    Free PMC article.
Chemotherapy-Induced Amenorrhea - An Update.
C Liedtke, L Kiesel.
Geburtshilfe Frauenheilkd, 2012 Sep 01; 72(9). PMID: 26640289    Free PMC article.
Chemotherapy in Premenopausal Breast Cancer Patients.
Ann H Partridge.
Breast Care (Basel), 2015 Dec 22; 10(5). PMID: 26688676    Free PMC article.
Review.
Adjuvant hormonal therapy in premenopausal women with breast cancer.
Lillian Smyth, Clifford Hudis.
Indian J Med Paediatr Oncol, 2016 Jan 27; 36(4). PMID: 26811586    Free PMC article.
Perceptions, Attributions, and Emotions Toward Endocrine Therapy in Young Women with Breast Cancer.
Hayley E Walker, Shoshana M Rosenberg, +2 authors, Ann H Partridge.
J Adolesc Young Adult Oncol, 2016 Jan 27; 5(1). PMID: 26812461    Free PMC article.
Survival Outcome of Combined GnRH Agonist and Tamoxifen Is Comparable to That of Sequential Adriamycin and Cyclophosphamide Chemotherapy Plus Tamoxifen in Premenopausal Patients with Lymph-Node-Negative, Hormone-Responsive, HER2-Negative, T1-T2 Breast Cancer.
Guiyun Sohn, Sei Hyun Ahn, +6 authors, Seunghee Baek.
Cancer Res Treat, 2016 Oct 19; 48(4). PMID: 27063654    Free PMC article.
SLCO1B1*5 polymorphism (rs4149056) is associated with chemotherapy-induced amenorrhea in premenopausal women with breast cancer: a prospective cohort study.
Toralf Reimer, Sarah Kempert, +3 authors, Dirk Koczan.
BMC Cancer, 2016 May 29; 16. PMID: 27234217    Free PMC article.
Significance of Ovarian Function Suppression in Endocrine Therapy for Breast Cancer in Pre-Menopausal Women.
A Scharl, A Salterberg.
Geburtshilfe Frauenheilkd, 2016 May 31; 76(5). PMID: 27239060    Free PMC article.
Review.
Real-world adjuvant TAC or FEC-D for HER2-negative node-positive breast cancer in women less than 50 years of age.
S Lupichuk, D Tilley, X Kostaras, A A Joy.
Curr Oncol, 2016 Jun 23; 23(3). PMID: 27330344    Free PMC article.
Therapeutic effect of taxanes on metastatic breast cancer of various immunohistochemical subtypes.
Ippei Fukada, Kazuhiro Araki, +6 authors, Yoshinori Ito.
Oncol Lett, 2016 Jun 28; 12(1). PMID: 27347197    Free PMC article.
The incidence of breast cancer in population of young women from Podkarpackie province in 2002-2011.
Aneta U Radziszewska, Bożenna Karczmarek-Borowska, Monika Grądalska-Lampart, Agata A Filip.
Contemp Oncol (Pozn), 2016 Jul 01; 20(2). PMID: 27358599    Free PMC article.
Comparison of adjuvant ED and EC-D regimens in operable breast invasive ductal carcinoma.
Liyu Jiang, Chuyu Jing, +6 authors, Qifeng Yang.
Oncol Lett, 2016 Jul 23; 12(2). PMID: 27446451    Free PMC article.
Ovarian Function Suppression in Premenopausal Women with Early-Stage Breast Cancer.
Matteo Lambertini, Lucia Del Mastro, +3 authors, Evandro de Azambuja.
Curr Treat Options Oncol, 2017 Feb 12; 18(1). PMID: 28185173
Review.
Accelerated versus standard epirubicin followed by cyclophosphamide, methotrexate, and fluorouracil or capecitabine as adjuvant therapy for breast cancer in the randomised UK TACT2 trial (CRUK/05/19): a multicentre, phase 3, open-label, randomised, controlled trial.
David Cameron, James P Morden, +22 authors, TACT2 Investigators.
Lancet Oncol, 2017 Jun 11; 18(7). PMID: 28600210    Free PMC article.
Sequential vs concurrent epirubicin and docetaxel as adjuvant chemotherapy for high-risk, node-negative, early breast cancer: an interim analysis of a randomised phase III study from the Hellenic Oncology Research Group.
Dimitrios Mavroudis, Emmanouil Saloustros, +12 authors, Vasilios Georgoulias.
Br J Cancer, 2017 Jun 24; 117(2). PMID: 28641315    Free PMC article.
Improved survival for sequentially as opposed to concurrently delivered neoadjuvant chemotherapy in non-metastatic breast cancer.
B E P J Vriens, I J H Vriens, +9 authors, Breast Cancer Trialists’ Group of the Netherlands (BOOG).
Breast Cancer Res Treat, 2017 Jul 05; 165(3). PMID: 28674765    Free PMC article.
Recent Advances in the Neoadjuvant Treatment of Breast Cancer.
Gábor Rubovszky, Zsolt Horváth.
J Breast Cancer, 2017 Jul 12; 20(2). PMID: 28690648    Free PMC article.
Review.
Association Between Background Parenchymal Enhancement and Pathologic Complete Remission Throughout the Neoadjuvant Chemotherapy in Breast Cancer Patients.
Chao You, Weijun Peng, +7 authors, Yajia Gu.
Transl Oncol, 2017 Aug 15; 10(5). PMID: 28806712    Free PMC article.
The Impact of Young Age for Prognosis by Subtype in Women with Early Breast Cancer.
Weibin Lian, Fangmeng Fu, +6 authors, Chuan Wang.
Sci Rep, 2017 Sep 16; 7(1). PMID: 28912475    Free PMC article.
Long-term Peripheral Neuropathy in Breast Cancer Patients Treated With Adjuvant Chemotherapy: NRG Oncology/NSABP B-30.
Hanna Bandos, Joy Melnikow, +9 authors, Patricia A Ganz.
J Natl Cancer Inst, 2017 Sep 28; 110(2). PMID: 28954297    Free PMC article.
Spotlight on triptorelin in the treatment of premenopausal women with early-stage breast cancer.
Marta Venturelli, Giorgia Guaitoli, Claudia Omarini, Luca Moscetti.
Breast Cancer (Dove Med Press), 2018 Mar 20; 10. PMID: 29551913    Free PMC article.
Review.
Adjuvant Chemotherapy Guided by a 21-Gene Expression Assay in Breast Cancer.
Joseph A Sparano, Robert J Gray, +27 authors, George W Sledge.
N Engl J Med, 2018 Jun 05; 379(2). PMID: 29860917    Free PMC article.
Highly Cited.
Treatment patterns for adjuvant docetaxel-based chemotherapy in early-stage breast cancer in China: A pooled retrospective analysis of four observational studies.
Binghe Xu, Zhimin Shao, +7 authors, Shu Wang.
Chin J Cancer Res, 2018 Jul 27; 30(3). PMID: 30046227    Free PMC article.
Prognostic Significance of Adjuvant Chemotherapy Induced Amenorrhea in Luminal A and B Subtypes.
Çetin Ordu, Kezban Nur Pilancı, +14 authors, Vahit Özmen.
Eur J Breast Health, 2018 Aug 21; 14(3). PMID: 30123884    Free PMC article.
A Single Institution Experience of Incorporation of Cisplatin into Adjuvant Chemotherapy for Patients With Triple-Negative Breast Cancer of Unknown BRCA Mutation Status.
Ying-Wen Su, Chia-Yen Hung, +2 authors, Po-Sheng Yang.
Clin Med Insights Oncol, 2018 Aug 29; 12. PMID: 30150877    Free PMC article.
Communicating Risks of Adjuvant Chemotherapy for Breast Cancer: Getting Beyond the Laundry List.
Eden R Brauer, Elisa F Long, +2 authors, Patricia A Ganz.
J Oncol Pract, 2018 Dec 15; 15(2). PMID: 30550372    Free PMC article.
Clinical and Genomic Risk to Guide the Use of Adjuvant Therapy for Breast Cancer.
Joseph A Sparano, Robert J Gray, +27 authors, George W Sledge.
N Engl J Med, 2019 Jun 04; 380(25). PMID: 31157962    Free PMC article.
Highly Cited.
Adjuvant Anti-HER2 Therapy, Treatment-Related Amenorrhea, and Survival in Premenopausal HER2-Positive Early Breast Cancer Patients.
Matteo Lambertini, Christine Campbell, +19 authors, Evandro de Azambuja.
J Natl Cancer Inst, 2018 Jun 08; 111(1). PMID: 29878225    Free PMC article.
Efficacy of anastrozole after tamoxifen in early breast cancer patients with chemotherapy-induced ovarian function failure.
Irene E G van Hellemond, Ingeborg J H Vriens, +15 authors, Dutch Breast Cancer Research Group (BOOG).
Int J Cancer, 2018 Dec 28; 145(1). PMID: 30588619    Free PMC article.
Increasing the dose intensity of chemotherapy by more frequent administration or sequential scheduling: a patient-level meta-analysis of 37 298 women with early breast cancer in 26 randomised trials.
Early Breast Cancer Trialists' Collaborative Group (EBCTCG).
Lancet, 2019 Feb 12; 393(10179). PMID: 30739743    Free PMC article.
Highly Cited.
Avoiding over- and undertreatment in patients with resected node-positive breast cancer with the use of gene expression signatures: are we there yet?
A Matikas, T Foukakis, S Swain, J Bergh.
Ann Oncol, 2019 May 28; 30(7). PMID: 31131397    Free PMC article.
Review.
Simulation Modeling to Extend Clinical Trials of Adjuvant Chemotherapy Guided by a 21-Gene Expression Assay in Early Breast Cancer.
Jinani Jayasekera, Joseph A Sparano, +5 authors, Jeanne Mandelblatt.
JNCI Cancer Spectr, 2020 Apr 28; 3(4). PMID: 32337487    Free PMC article.
Clinical Characteristics and Outcome Trends of Adjuvant Anthracycline and Taxane Regimen for Early Stage Breast Cancer.
Ashok K Vaid, Aseem Khurana, +6 authors, Kush Gupta.
World J Oncol, 2020 Jun 05; 11(3). PMID: 32494317    Free PMC article.
Efficacy of neoadjuvant endocrine therapy compared with neoadjuvant chemotherapy in pre-menopausal patients with oestrogen receptor-positive and HER2-negative, lymph node-positive breast cancer.
Hee Jeong Kim, Woo Chul Noh, +7 authors, Sei Hyun Ahn.
Breast Cancer Res, 2020 May 29; 22(1). PMID: 32460816    Free PMC article.
Late effects of adjuvant chemotherapy adumbrate dormancy complexity in breast cancer.
Romano Demicheli, Christine Desmedt, +3 authors, Elia Biganzoli.
Breast, 2020 May 20; 52. PMID: 32428688    Free PMC article.
Cancer Treatment-Related Infertility: A Critical Review of the Evidence.
Philip D Poorvu, A Lindsay Frazier, +6 authors, Ann H Partridge.
JNCI Cancer Spectr, 2019 Jul 31; 3(1). PMID: 31360893    Free PMC article.
Review.
The Prognostic Impact of Age at Diagnosis Upon Breast Cancer of Different Immunohistochemical Subtypes: A Surveillance, Epidemiology, and End Results (SEER) Population-Based Analysis.
Shibin Cai, Wenjia Zuo, +5 authors, Shuzheng Chen.
Front Oncol, 2020 Oct 20; 10. PMID: 33072554    Free PMC article.
The taxane-based chemotherapy triplet is superior to the doublet in one to nine node-positive but not node-negative triple-negative breast cancer: results from a retrospective analysis.
Sanxing Guo, Yonggang Shi, +4 authors, Xingya Li.
J Cancer, 2020 Oct 14; 11(22). PMID: 33046986    Free PMC article.
Interdisciplinary Screening, Diagnosis, Therapy and Follow-up of Breast Cancer. Guideline of the DGGG and the DKG (S3-Level, AWMF Registry Number 032/045OL, December 2017) - Part 2 with Recommendations for the Therapy of Primary, Recurrent and Advanced Breast Cancer.
Achim Wöckel, Jasmin Festl, +94 authors, Stephanie Stangl.
Geburtshilfe Frauenheilkd, 2018 Dec 26; 78(11). PMID: 30581198    Free PMC article.
Sequential vs concurrent adjuvant chemotherapy of anthracycline and taxane for operable breast cancer.
Wanjing Chen, Qian Tu, +3 authors, Yong Shen.
World J Surg Oncol, 2021 Feb 20; 19(1). PMID: 33602236    Free PMC article.