Tamoxifen as an alternative to surgical resection for selected geriatric patients with primary breast cancer

Thirty elderly patients with primary operable breast cancer were treated initially, because of refusal of surgery or because of infirmity, only with the antiestrogen tamoxifen citrate. Nineteen patients had regression of the primary tumor (complete in five and partial in 14). Eight patients were stable with no change, and three had measurable increases in the size of their primary tumors. Nine of the 30 eventually required locoregional treatment with surgery or radiotherapy for progression or recrudescence of their tumors after initial regression. No patient developed uncontrollable locoregional disease. For selected geriatric patients, treatment with tamoxifen alone permits a delay of surgery, which for some exceeds life expectancy.