Effect of local therapy on locoregional recurrence in postmenopausal women with breast cancer in the Tamoxifen Exemestane Adjuvant Multinational (TEAM) trial

Research output: Contribution to journalArticlepeer-review


  • Marjan Van Hezewijk
  • Esther Bastiaannet
  • Hein Putter
  • Astrid N. Scholten
  • Gerrit Jan Liefers
  • Annette Hasenburg
  • Robert Paridaens
  • Yasuo Hozumi
  • Christos Markopoulos
  • Caroline Seynaeve
  • Stephen E. Jones
  • Corrie A.M. Marijnen
  • Cornelis J.H. Van De Velde

Colleges, School and Institutes

External organisations

  • Leiden University Medical Center - LUMC
  • University Hospital
  • Leuven Cancer Institute
  • Jichi Medical University
  • Athens University
  • Erasmus MC
  • US Oncology Research


Background and purpose The TEAM trial investigated the efficacy and safety of adjuvant endocrine therapy consisting of either exemestane or the sequence of tamoxifen followed by exemestane in postmenopausal hormone-sensitive breast cancer. The present analyses explored the association between locoregional therapy and recurrence (LRR) in this population. Material and methods Between 2001 and 2006, 9779 patients were randomized. Local treatment was breast conserving surgery plus radiotherapy (BCS + RT), mastectomy without radiotherapy (MST-only), or mastectomy plus radiotherapy (MST + RT). Patients with unknown data on surgery, radiotherapy, tumor or nodal stage (n = 199), and patients treated by lumpectomy without radiotherapy (n = 349) were excluded. Results After a median follow-up of 5.2 years, 270 LRRs occurred (2.9%) among 9231 patients. The 5-years actuarial incidence of LRR was 4.2% (95% CI 3.3-4.9%) for MST-only, 3.4% (95% CI 2.4-4.2%) for MST + RT and 1.9% (95% CI 1.5-2.3%) for BCS + RT. After adjustment for prognostic factors, the hazard ratio (HR, reference BCS + RT) for LRR remained significantly higher for MST-only (HR 1.53; 95% CI 1.10-2.11), not for MST + RT (HR 0.78; 95% CI 0.50-1.22). Conclusion This explorative analysis showed a higher LRR risk after MST-only than after BCS + RT, even after adjustment for prognostic factors. As this effect was not seen for MST + RT versus BCS + RT, it might be explained by the beneficial effects of radiation treatment.


Original languageEnglish
Pages (from-to)190-196
Number of pages7
JournalRadiotherapy and Oncology
Issue number2
Publication statusPublished - 1 Aug 2013


  • Breast cancer, Breast conserving surgery, Locoregional recurrence, Mastectomy, Postmenopausal women, Radiation

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