Efficacy and safety of endocrine therapy after mastectomy in patients with hormone receptor positive breast ductal carcinoma in situ: Retrospective cohort study.

Abstract

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).

• Authors: 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
• Journal: eLife (Elife) Vol. 12 (02 06 2023) ISSN: 2050-084X [Electronic] England
• PMID: 36745010 (Publication Type: Multicenter Study, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2023, Niu, Zhang, Bai et al.

Topics

• Humans
• Female
• Mastectomy (adverse effects)
• Carcinoma, Intraductal, Noninfiltrating (drug therapy, surgery, pathology)
• Retrospective Studies
• Breast Neoplasms (drug therapy, surgery, complications)
• Neoplasm Recurrence, Local