In The Lancet, the Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) have updated their meta-analyses of long-term outcomes in 21 457 women with early-stage breast cancer, in 20 randomised trials of about 5 years of adjuvant tamoxifen versus observation or placebo. The EBCTCG should be commended for their commitment to update and investigate a collaborative database with such breadth and maturity (median follow-up is now 13 years). They showed that allocation to about 5 years of tamoxifen reduces the recurrence rate substantially throughout the first decade (rate ratio [RR] 0·53 [SE 0·03] in years 0–4 and 0·68 [0·06] in years 5–9), with no subsequent loss of the gains made during the first decade.