Trends in Adjuvant Chemotherapy Use in Endocrine-Sensitive, HER-۲ Negative Breast Cancer, With ۱ to ۳ Positive Nodes: A Single-Centre Study

Background: There is a tendency to decrease the intensity of breast cancertreatments, e.g. omitting adjuvant chemotherapy in endocrine-sensitive and HER-۲ negative patients. The purpose of this study was to analyse changes in thefrequency of the indication of adjuvant chemotherapy and the differences insurvival over time for this subtype of breast cancer, with ۱–۳ positive nodes.Methods: The study was based on descriptive, observational, retrospective,single-institution research between ۲۰۰۴–۱۰ and ۲۰۱۱–۱۸, on endocrine-sensitive,HER-۲ negative breast cancer, stage pN۱ (۱–۳ nodes). The analytical tests carriedout for a comparison of the frequency of chemotherapy use the chi-square test withFisher's exact test. Survival data in both periods are presented.Results: A total of ۲۳۶ patients were included, ۶۶ for the period ۲۰۰۴–۱۰, and۱۷۰ for ۲۰۱۱–۱۸. More patients were treated with hormone therapy alone in۲۰۱۱–۱۸: hormone therapy alone ۱۰/۶۶ (۱۵.۲۰%) for ۲۰۰۴–۱۰, and ۸۳/۱۶۹(۴۹.۱۰%) for ۲۰۱۱–۱۸; chemotherapy-hormone therapy ۵۶/۶۶ (۸۴.۸۰%) for۲۰۰۴–۱۰, and ۸۶/۱۶۹ (۵۰.۹۰%) for ۲۰۱۱–۱۸ (P = ۰.۰۰۰۱). For ۲۰۰۴–۱۰, the ۵-yearoverall survival probability was ۱۰۰%. For ۲۰۱۱–۱۸ it was ۹۸.۲۰% (۹۵% CI۹۵.۶۵–۱۰۰). For ۲۰۰۴-۱۰, ۵-year disease free survival (DFS) was ۹۶.۹% (۹۵% CI۹۲.۷–۱۰۱). For ۲۰۱۱–۱۸ it was ۸۷.۷% (۹۵% CI ۸۱.۸–۹۳.۵) (P=۰,۰۴۰). For۲۰۰۴–۱۰ the ۵ year distant relapse free interval was ۹۶.۹% (۹۵% CI ۹۲.۵–۱۰۱.۲).For ۲۰۱۱–۱۸ it was ۹۳% (۹۵% CI ۸۸.۱–۹۷.۹) (P=۰.۳۱۲).Conclusion: A decrease in the indication of adjuvant chemotherapy accordingto the clinical risk is confirmed in endocrine-sensitive, HER-۲ negative breastcancer, with ۱-۳ positive nodes, over the period ۲۰۱۱–۱۸ compared to ۲۰۰۴–۱۰.Based on the results, ۵-year DFS is slightly worse in the ۲۰۱۱–۱۸ period.

کلیدواژه ها:

Breast neoplasm ، hormonal antineoplastic agents ، adjuvant chemotherapy ، survival ، systemic adjuvant therapies.