Abstract
Background: The Nottingham Elderly Primary Series I (EPSI), in which patients were randomised to primary tamoxifen or initial surgery, found that in oestrogen receptor (ER) unselected cases surgery achieved better local control but no overall survival advantage. However, analysis of EPSI by ER status suggested that the selection of patients with ER-rich tumours may lead to comparable local control and survival rates. Nottingham EPSII is a randomised trial designed to test this hypothesis, and we now present its final analysis at 20 years.
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