first survival Initial report in 1996 reported differences in first site of recurrences.
Time to distance recurrence was significantly different.
However, with 10-yr follow up all the difference disappeared.
Chemotherapy may delay median time to distant recurrence but does not change the overall rate of distance recurrence or survival.
Close and positive margins have high rate of local recurrences and should be re-resected.
DFS and OS is same.
~ 5% more lumpectomies in large tumors (15.9% IBTR in this groups vs. 9.9% IBTR in patients who had lumpectomy as planned).
Pre-operative arm had non-significant increase in IBTR of 10.7% vs 7.6%.
No difference in DFS or OS.
No detrimental effect to giving RT and TAM together.
Theoretically, TAM blocks G1 to mid-G1 transition thereby placing cells in RT resistant phase.
While not in favor there are multiple randomized trials which show local control benefit while being safe.