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KMID : 0371420221030060313
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Annals of Surgical Treatment and Research
2022 Volume.103 No. 6 p.313 ~ p.322
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Omission of chemotherapy for hormone receptor-positive and human epidermal growth factor receptor 2-negative breast cancer: patterns of treatment and outcomes from the Korean Breast Cancer Society Registry
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Kangleon-Tan Hannah Lois
Sim Jong-Min
You Ji-Young
Lee Eun-Shin
Lee Hae-Min
Yang Sun-Moon
Seong Min-Ki
Park Eun-Hwa
Nam Seok-Jin
Park Min-Ho
Lee Seok-Won
Park Woo-Chan
Kangleon Rogelio G. Jr
Dy Crisostomo B.
Bae Soo-Youn
Jung Seung-Pil
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Abstract
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Purpose: Although adjuvant chemotherapy (CTx) is still recommended for high-risk patients with hormone receptor-positive and human epidermal receptor (HER)-2-negative breast cancer, recent studies found that selected patients with low disease burden may be spared from CTx and receive hormonal treatment (HT) alone. This study aims to evaluate the trends of treatment (CTx + HT vs. HT alone) in Korea and to assess the impact on overall survival (OS) according to treatment pattern.
Methods: The Korean Breast Cancer Society Registry was queried (2000 to 2018) for women with pT1-2N0-1 hormone receptor-positive and HER2-negative disease who underwent surgery and adjuvant systemic treatment (CTx and HT). Clinicopathologic factors, change in pattern of treatment over time, and OS for each treatment option were analyzed.
Results: A total of 40,938 women were included in the study; 20,880 (51.0%) received CTx + HT, while 20,058 (49.0%) received HT only. In recent years, there has been a steady increase in the use of HT alone, from 21.0% (2000) to 64.6% (2018). In Cox regression analysis, age, type of breast and axillary operations, T and N stages, body mass index, histologic grade, and presence of lymphovascular invasion were prognostic indicators for OS. There was no significant difference between CTx + HT and HT alone in terms of OS (P = 0.126).
Conclusion: Over the years, there has been a shift from CTx + HT to HT alone without a significant difference in OS. Therefore, HT alone could be a safe treatment option in selected patients, even those with T2N1 disease.
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KEYWORD
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Breast neoplasms, Drug therapy, Estrogen receptor, Hormone antagonists, Prognosis
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