Efficacy and safety of endocrine therapy after mastectomy in patients with hormone receptor positive breast ductal carcinoma in situ: Retrospective cohort study
Background: More than half of Chinese patients with hormone receptor positive (HR+) ductal carcinoma in situ (DCIS) are treated with mastectomy, and usually subjected to postoperative endocrine therapy (ET). Given that long-term ET can cause severe adverse effects it is important to determine the be...
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| Format: | Article |
| Language: | English |
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eLife Sciences Publications Ltd
2023-02-01
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| Series: | eLife |
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| Online Access: | https://elifesciences.org/articles/83045 |
| _version_ | 1811170693402853376 |
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| author | Nan Niu Yinan Zhang Yang Bai Xin Wang Shunchao Yan Dong Song Hong Xu Tong Liu Bin Hua Yingchao Zhang Jinchi Liu Xinbo Qiao Jiaxiang Liu Xinyu Zheng Hongyi Cao Caigang Liu |
| author_facet | Nan Niu Yinan Zhang Yang Bai Xin Wang Shunchao Yan Dong Song Hong Xu Tong Liu Bin Hua Yingchao Zhang Jinchi Liu Xinbo Qiao Jiaxiang Liu Xinyu Zheng Hongyi Cao Caigang Liu |
| author_sort | Nan Niu |
| collection | DOAJ |
| description | Background: More than half of Chinese patients with hormone receptor positive (HR+) ductal carcinoma in situ (DCIS) are treated with mastectomy, and usually subjected to postoperative endocrine therapy (ET). Given that long-term ET can cause severe adverse effects it is important to determine the beneficial effect and safety of post-mastectomy ET on the disease-free survival (DFS) and adverse events in patients with HR+ DCIS.
Methods: To explore beneficial effect and safety of post-mastectomy ET in patients with HR+ DCIS, we performed a multicenter, population-based study. This retrospective study analyzed the DFS and adverse events in 1037 HR+ DCIS Chinese patients with or without post-mastectomy ET from eight breast centers between 2006 and 2016. The median follow-up time period was 86 months.
Results: There were 791 DCIS patients receiving ET (ET group). Those patients were followed up for a median of 86 months (range, 60–177 months). There were 23 cases with tumor recurrence or distant metastasis. There were similar 5-year DFS rates and DFS between the ET and non-ET groups, even for those with high-risk factors. Conversely, 37.04% of patients suffered from adverse events after ET, which were significantly higher than those in the non-ET group.
Conclusions: ET after mastectomy did not benefit patients with HR+ DCIS for their DFS, rather increased adverse events in those patients. Therefore, ET after mastectomy may not be recommended for patients with HR+ DCIS, even for those with high-risk factors, such as multifocal, microinvasive, and higher T stage.
Funding: This study was supported by grants from Outstanding Scientific Fund of Shengjing Hospital (201803) and Outstanding Young Scholars of Liaoning Province (2019-YQ-10). |
| first_indexed | 2024-04-10T17:00:53Z |
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| id | doaj.art-95310d04f8ac4818a2b9a04d4ee80f38 |
| institution | Directory Open Access Journal |
| issn | 2050-084X |
| language | English |
| last_indexed | 2024-04-10T17:00:53Z |
| publishDate | 2023-02-01 |
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| spelling | doaj.art-95310d04f8ac4818a2b9a04d4ee80f382023-02-06T14:25:42ZengeLife Sciences Publications LtdeLife2050-084X2023-02-011210.7554/eLife.83045Efficacy and safety of endocrine therapy after mastectomy in patients with hormone receptor positive breast ductal carcinoma in situ: Retrospective cohort studyNan Niu0https://orcid.org/0000-0002-8206-941XYinan Zhang1Yang Bai2Xin Wang3Shunchao Yan4Dong Song5Hong Xu6Tong Liu7Bin Hua8Yingchao Zhang9Jinchi Liu10Xinbo Qiao11https://orcid.org/0000-0002-6759-921XJiaxiang Liu12Xinyu Zheng13Hongyi Cao14Caigang Liu15https://orcid.org/0000-0003-2083-235XDepartment of Oncology, Shengjing Hospital of China Medical University, Shenyang, ChinaDepartment of Oncology, Shengjing Hospital of China Medical University, Shenyang, ChinaDepartment of Nursing, Shengjing Hospital of China Medical University, Shenyang, ChinaDepartment of Breast Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Beijing, ChinaDepartment of Oncology, Shengjing Hospital of China Medical University, Shenyang, ChinaDepartment of Breast Surgery, the First Hospital of Jilin University, Changchun, ChinaDepartment of Breast Surgery, Liaoning Cancer Hospital and Institute, Shenyang, ChinaDepartment of Breast Surgery, Cancer Hospital of Harbin Medical University, Harbin, ChinaDepartment of General Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Beijing, ChinaDepartment of Breast Surgery, the Second Hospital of Jilin University, Changchun, ChinaDepartment of Oncology, Shengjing Hospital of China Medical University, Shenyang, ChinaDepartment of Oncology, Shengjing Hospital of China Medical University, Shenyang, ChinaDepartment of Breast Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Beijing, ChinaDepartment of Breast Surgery, the First Affiliated Hospital of China Medical University, Shenyang, ChinaDepartment of Pathology, the First Affiliated Hospital of China Medical University and College of Basic Medical Sciences, Shenyang, ChinaDepartment of Oncology, Shengjing Hospital of China Medical University, Shenyang, ChinaBackground: More than half of Chinese patients with hormone receptor positive (HR+) ductal carcinoma in situ (DCIS) are treated with mastectomy, and usually subjected to postoperative endocrine therapy (ET). Given that long-term ET can cause severe adverse effects it is important to determine the beneficial effect and safety of post-mastectomy ET on the disease-free survival (DFS) and adverse events in patients with HR+ DCIS. Methods: To explore beneficial effect and safety of post-mastectomy ET in patients with HR+ DCIS, we performed a multicenter, population-based study. This retrospective study analyzed the DFS and adverse events in 1037 HR+ DCIS Chinese patients with or without post-mastectomy ET from eight breast centers between 2006 and 2016. The median follow-up time period was 86 months. Results: There were 791 DCIS patients receiving ET (ET group). Those patients were followed up for a median of 86 months (range, 60–177 months). There were 23 cases with tumor recurrence or distant metastasis. There were similar 5-year DFS rates and DFS between the ET and non-ET groups, even for those with high-risk factors. Conversely, 37.04% of patients suffered from adverse events after ET, which were significantly higher than those in the non-ET group. Conclusions: ET after mastectomy did not benefit patients with HR+ DCIS for their DFS, rather increased adverse events in those patients. Therefore, ET after mastectomy may not be recommended for patients with HR+ DCIS, even for those with high-risk factors, such as multifocal, microinvasive, and higher T stage. Funding: This study was supported by grants from Outstanding Scientific Fund of Shengjing Hospital (201803) and Outstanding Young Scholars of Liaoning Province (2019-YQ-10).https://elifesciences.org/articles/83045breast ductal carcinoma in situmastectomyhormone receptor positiveendocrine therapydisease-free survival |
| spellingShingle | Nan Niu Yinan Zhang Yang Bai Xin Wang Shunchao Yan Dong Song Hong Xu Tong Liu Bin Hua Yingchao Zhang Jinchi Liu Xinbo Qiao Jiaxiang Liu Xinyu Zheng Hongyi Cao Caigang Liu Efficacy and safety of endocrine therapy after mastectomy in patients with hormone receptor positive breast ductal carcinoma in situ: Retrospective cohort study eLife breast ductal carcinoma in situ mastectomy hormone receptor positive endocrine therapy disease-free survival |
| title | Efficacy and safety of endocrine therapy after mastectomy in patients with hormone receptor positive breast ductal carcinoma in situ: Retrospective cohort study |
| title_full | Efficacy and safety of endocrine therapy after mastectomy in patients with hormone receptor positive breast ductal carcinoma in situ: Retrospective cohort study |
| title_fullStr | Efficacy and safety of endocrine therapy after mastectomy in patients with hormone receptor positive breast ductal carcinoma in situ: Retrospective cohort study |
| title_full_unstemmed | Efficacy and safety of endocrine therapy after mastectomy in patients with hormone receptor positive breast ductal carcinoma in situ: Retrospective cohort study |
| title_short | Efficacy and safety of endocrine therapy after mastectomy in patients with hormone receptor positive breast ductal carcinoma in situ: Retrospective cohort study |
| title_sort | efficacy and safety of endocrine therapy after mastectomy in patients with hormone receptor positive breast ductal carcinoma in situ retrospective cohort study |
| topic | breast ductal carcinoma in situ mastectomy hormone receptor positive endocrine therapy disease-free survival |
| url | https://elifesciences.org/articles/83045 |
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