NSABP Members' Area
  Password Protected - Access
  Limited to NSABP Participating
  Institutions Only

NSABP Foundation, Inc.

General NSABP Information
  Financial Conflicts of
     Interest Policy
  Coalition Comment:
  IOM Report Group Comment
  Contact the NSABP
  Pathology Section
  Future Meetings
  NSABP Newsletters
  Media Info on STAR

Clinical Trials Information
  Clinical Trials Overview
  Protocol Chart
  Never Say Lost

Treatment Trials Information
  Protocol B-51
  Protocol B-52
  Protocol B-53/S1207
  Protocol B-55/BIG 6-13

Prevention Trials Information
  Protocol P-1 - BCPT
  Protocol P-2 - STAR
  Protocol P-5

Scientific Publications

Related Web Sites

Medical Search Engines

To report problems, ask
questions or make comments,
please send e-mail to:

Annotated Bibliography of NSABP Publications

Tamoxifen and chemotherapy for lymph node-negative, estrogen receptor-positive breast cancer
Fisher B, Dignam J, Wolmark N, DeCillis A, Emir B, Wickerham DL, Bryant J, Dimitrov N, Abramson N, Atkins J, Shibata H, Deschenes L, Margolese R
Journal of the National Cancer Institute 89.22:1673-1682, 1997

Purpose: The B-20 study of the National Surgical Adjuvant Breast and Bowel Project (NSABP) was conducted to determine whether chemotherapy plus tamoxifen would be of greater benefit than tamoxifen alone in the treatment of patients with axillary lymph node-negative, estrogen receptor-positive breast cancer.

Methods: Eligible patients (n=2306) were randomly assigned to one of three treatment groups following surgery. A total of 771 patients with follow-up data received tamoxifen alone; 767 received methotrexate, fluorouracil, and tamoxifen (MFT); and 768 received cyclophosphamide, methotrexate, fluorouracil, and tamoxifen (CMFT). The Kaplan-Meier method was used to estimate disease-free survival, distant disease-free survival, and survival. Reported P values are two-sided.

Results: Through 5 years of follow-up, chemotherapy plus tamoxifen resulted in significantly better disease-free survival than tamoxifen alone (90% for MFT versus 85% for tamoxifen [P=.001]; 89% for CMFT versus 85% for tamoxifen [P=.001]). A similar benefit was observed in both distant disease-free survival (92% for MFT versus 87% for tamoxifen [P=008]; 91% for CMFT versus 87% for tamoxifen [P=.006]) and survival (97% for MFT versus 94% for tamoxifen [P=.05]; 96% for CMFT versus 94% for tamoxifen [P=.03]). Compared with tamoxifen alone, MFT nd CMFT reduced the risk of ipsilateral breast tumor recurrence after lumpectomy and the risk of recurrence at other local, regional, and distant sites. Risk of treatment failure was reduced after both types of chemotherapy, regardless of tumor size, tumor estrogen or progesterone receptor level, or patient age; however, the reduction was greatest in patients aged 49 years of less. No subgroup of patients evaluated in this study failed to benefit from chemotherapy.

Conclusions: Findings from this and other NSABP studies indicate that patients with breast cancer who meet NSABP protocol criteria, regardless of age, lymph node status, tumor size, or estrogen receptor status, are candidates for chemotherapy.

National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA.