Ethier JL, Anderson GM, Austin PC, et al. - In this secondary analysis of the MA.27, MA.17 and MA.17R trials of adjuvant endocrine therapy in early breast cancer, researchers investigated how competing risks of death could impact estimates of disease recurrence and benefit from therapy. Non-breast cancer deaths more often were evident in older participants, in those carrying a lower risk of breast cancer and following longer follow-up. Competing risk analyses, vs Kaplan-Meier (KM) methods, led to lower estimates of disease-free survival and distant recurrence-free survival events as well as similar or modestly lower absolute advantage from experimental endocrine therapy. Over a long time horizon, the likely preferable option is competing risk methods instead of KM methods, when estimating future risk of recurrence in early-stage hormone-sensitive breast cancer.