Early Breast Cancer Trialists' Collaborative Group (EBCTCG)
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200,000 women in 400 randomised trials
Every five years, CTSU brings together updated data on each woman randomised into all trials of the treatment of operable breast cancer. The EBCTCG process was initiated in 1983; the first cycle collected data for hormonal and cytotoxic therapy in 1985 [6a, 6b]; the collaboration was extended in the 1990 cycle to all aspects of early breast cancer management [7a, 7b]; and new trials and further follow-up were collected in 1995 [8a-8d].
The fourth cycle (200,000 women; 400 randomised trials; 250 trial groups) was presented to the collaboration for discussion in 2000, and its detailed results informed the subsequent NIH consensus development conference on the treatment of early breast cancer, which became available online later that year and was published in 2001 [9] . The report on chemotherapy and endocrine therapy [10a] shows the substantial effects on 15-year survival of the chemotherapy regimens (such as about 6 months of FAC or FEC in women aged <70) and hormonal regimens (such as at least 5 years of tamoxifen in women with ER+ disease) that were being tested in the 1980s. The report on surgery and radiotherapy [10b] shows that treatments that substantially improve local control have little effect on breast cancer mortality during the first few years, but have definite, although moderate, effects by 15 years, and that avoidance of local recurrence in a conserved breast and elsewhere are of comparable relevance to 15-year breast cancer mortality. In the hypothetical absence of other causes of death, about one breast cancer death over the next 15 years would be avoided for every four local recurrences avoided.
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