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This is a secondary analysis of the STO\u20103 trial including 559 postmenopausal breast cancer patients by PR levels. Patients were randomly assigned to at least 2\u2009years of adjuvant tamoxifen therapy (40\u2009mg once daily) versus no endocrine therapy in the Stockholm (STO)\u20103 trial. Twenty\u2010five\u2010year distant recurrence\u2010free interval (DRFI) was assessed by Kaplan\u2013Meier, multivariable Cox proportional hazard regression, and multivariable time\u2010varying analyses. Univariable Kaplan\u2013Meier analysis showed a significant long\u2010term tamoxifen benefit for PR\u2010positive disease using a threshold of 10% or greater (DRFI, tamoxifen treated 85% vs. control 68%;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u2009.0001). Similarly, patients with high PR gene expressing tumors had a significant long\u2010term tamoxifen therapy benefit (DRFI, tamoxifen treated 84% vs. control 66%; log\u2010rank\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u2009.001). In contrast, we report no significant therapy benefit for patients with PR\u2010negative disease (DRFI, tamoxifen treated 79% vs. control 70%; log\u2010rank\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u2009.14) or low PR gene expression (DRFI, tamoxifen treated 82% vs. control 74%; log\u2010rank\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u2009.17). Multivariable Cox proportional hazard regression modelling confirmed the univariable findings for PR\u2010positive disease (HR\u2009=\u20090.37; 95% CI [0.23\u20130.61]). Time\u2010varying analysis revealed a treatment benefit for PR\u2010positive disease up to 25\u2009years (HR\u2009=\u20090.35; 95% CI [0.16\u20130.79]), but not for patients with PR\u2010negative tumors. PR\u2010positivity as determined by immunohistochemistry predicted long\u2010term benefit from adjuvant tamoxifen in lymph node\u2010negative postmenopausal breast cancer patients with ER+\/HER2\u2212 tumors.\n                  <\/jats:p>","DOI":"10.1002\/ijc.70409","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T10:12:07Z","timestamp":1772964727000},"page":"450-459","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long\u2010term benefit from adjuvant tamoxifen therapy for\n                    <scp>ER<\/scp>\n                    +\n                    <scp>HER2\u2212<\/scp>\n                    breast cancer by\n                    <scp>PR<\/scp>\n                    positivity"],"prefix":"10.1002","volume":"159","author":[{"given":"Anna E.","family":"Nordenskj\u00f6ld","sequence":"first","affiliation":[{"name":"Institution of Clinical Sciences, Department of Oncology Sahlgrenska Academy at Gothenburg University  Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena","family":"R\u00edos\u2010Romero","sequence":"additional","affiliation":[{"name":"Department of Oncology and Pathology Karolinska Institutet  Stockholm Sweden"},{"name":"Breast Center, Karolinska Comprehensive Cancer Center Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huma","family":"Dar","sequence":"additional","affiliation":[{"name":"Department of Oncology and Pathology Karolinska Institutet  Stockholm Sweden"},{"name":"Breast Center, Karolinska Comprehensive Cancer Center Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tommy","family":"Fornander","sequence":"additional","affiliation":[{"name":"Department of Oncology and Pathology Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gizeh","family":"Perez\u2010Tenorio","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Clinical Sciences Link\u00f6ping University  Link\u00f6ping Sweden"},{"name":"Department of Oncology Link\u00f6ping University  Link\u00f6ping Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena","family":"Fohlin","sequence":"additional","affiliation":[{"name":"Regional Cancer Center South\u2010East Sweden, Department of Biomedical and Clinical Sciences Link\u00f6ping University  Link\u00f6ping Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olle","family":"St\u00e5l","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Clinical Sciences Link\u00f6ping University  Link\u00f6ping Sweden"},{"name":"Department of Oncology Link\u00f6ping University  Link\u00f6ping 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