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January 19, 2000

Estrogen-Receptor Status in Breast Cancer—Reply

Author Affiliations

Phil B.FontanarosaMD, Deputy EditorIndividualAuthorMargaret A.WinkerMD, Deputy EditorIndividualAuthorStephen J.LurieMD, PhD, Fishbein FellowIndividualAuthor

JAMA. 2000;283(3):338-339. doi:10-1001/pubs.JAMA-ISSN-0098-7484-283-3-jac90010

In Reply: The ER status of breast cancer was determined based on clinical reports from the numerous sites that participated in this international study; it was not feasible to mandate a single method. Variability in the assessment of ER status might have led our study to underestimate the differential effect of raloxifene on ER-positive and ER-negative cancer; however, we found that these effects of raloxifene on risk of ER-positive and ER-negative cancer were extremely different.

We disagree with Mr Kuo's assertion that the RR calculation should be based only on participants who had ER-positive cancer. We believe that the RR of ER-positive and ER-negative cancer was appropriately calculated by comparing the rates of each type of cancer in the treatment group vs the placebo group.