Volume 381, Issue 9869, Pages 805-816 (March 2013) Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years after diagnosis of oestrogen receptor-positive breast cancer: ATLAS, a randomised trial  Dr Christina Davies, MBChB, Hongchao Pan, PhD, Jon Godwin, DPhil, Prof Richard Gray, MSc, Prof Rodrigo Arriagada, MD, Prof Vinod Raina, MD, Mirta Abraham, MD, Victor Hugo Medeiros Alencar, MD, Atef Badran, PhD, Xavier Bonfill, MD, Joan Bradbury, Prof Michael Clarke, DPhil, Prof Rory Collins, FMedSci, Prof Susan R Davis, MBBS, Antonella Delmestri, PhD, Prof John F Forbes, MD, Prof Peiman Haddad, MD, Prof Ming-Feng Hou, MD, Prof Moshe Inbar, MD, Prof Hussein Khaled, MD, Joanna Kielanowska, MD, Wing-Hong Kwan, MD, Beela S Mathew, MD, Prof Indraneel Mittra, PhD, Bettina Müller, MD, Antonio Nicolucci, MD, Octavio Peralta, MD, Fany Pernas, Prof Lubos Petruzelka, MD, Prof Tadeusz Pienkowski, MD, Ramachandran Radhika, MD, Balakrishnan Rajan, MD, Maryna T Rubach, MD, Sera Tort, MD, Gerard Urrútia, MD, Miriam Valentini, MD, Yaochen Wang, MD, Prof Richard Peto, FRS  The Lancet  Volume 381, Issue 9869, Pages 805-816 (March 2013) DOI: 10.1016/S0140-6736(12)61963-1 Copyright © 2013 Elsevier Ltd Terms and Conditions

Figure 1 Trial profile, showing the different populations analysed to assess the side-effects and the main effects of continuing tamoxifen to 10 years versus stopping tamoxifen at 5 years ER=oestrogen receptor. *39 patients were allocated twice in error, but stayed on their original allocation. Excludes 18 patients entered in error (17 with distant recurrence and one without ethics approval). The Lancet 2013 381, 805-816DOI: (10.1016/S0140-6736(12)61963-1) Copyright © 2013 Elsevier Ltd Terms and Conditions

Figure 2 Treatment compliance (A) and proportion of patients in follow-up (B) by year since randomisation for 6846 women with ER-positive disease (54% node-negative) *>99% tamoxifen. The Lancet 2013 381, 805-816DOI: (10.1016/S0140-6736(12)61963-1) Copyright © 2013 Elsevier Ltd Terms and Conditions

Figure 3 Recurrence (A) and breast cancer mortality (B) by treatment allocation for 6846 women with ER-positive disease Bars show SE. Recurrence rates are percentage per year (events/patient-years of follow-up). Death rates (overall rate – rate in women without recurrence) are percentage per year (SE). ATLAS=Adjuvant Tamoxifen: Longer Against Shorter. The Lancet 2013 381, 805-816DOI: (10.1016/S0140-6736(12)61963-1) Copyright © 2013 Elsevier Ltd Terms and Conditions

Figure 4 Recurrence by treatment allocation for 6846 women with ER-positive disease, subdivided by patient or tumour characteristics and location or time of first recurrence *Europe, Australia, New Zealand, USA, Latin America, and South Africa (all predominantly of European origin). †Including multiple and unspecified sites. The Lancet 2013 381, 805-816DOI: (10.1016/S0140-6736(12)61963-1) Copyright © 2013 Elsevier Ltd Terms and Conditions