Breast Cancer · Medical · Adjuvant Endocrine Therapy / Locoregional Therapy
DBCG 82C
In high-risk postmenopausal breast cancer treated with tamoxifen, does adding postmastectomy radiotherapy improve recurrence and survival?
Tumour site
Breast Cancer
Discipline
Medical
Clinical setting
Adjuvant Endocrine Therapy / Locoregional Therapy
Evidence type
Comparative clinical evidence
Absolute Effect
DBCG 82C randomized postmenopausal women to tamoxifen alone or tamoxifen plus chest-wall and regional radiotherapy. Locoregional recurrence was 8% versus 35%, disease-free survival 36% versus 24%, and 10-year overall survival 45% versus 36%, favouring radiotherapy plus tamoxifen.
NNT / NNH: Calculated only when a defensible fixed-time absolute event difference is available. Hazard ratios alone are not converted into NNT.
Clinical interpretation
The large locoregional-control improvement supports postmastectomy radiotherapy in selected high-risk postmenopausal node-positive disease, while modern treatment should be individualized.
Limitations
The trial used historical tamoxifen-era systemic therapy; current tumour biology, systemic treatment, nodal burden and modern dose planning modify absolute benefit.