Early Discontinuation of Endocrine Therapy and Recurrence of Breast Cancer among Premenopausal Women.
Journal
Clinical cancer research : an official journal of the American Association for Cancer Research
ISSN: 1557-3265
Titre abrégé: Clin Cancer Res
Pays: United States
ID NLM: 9502500
Informations de publication
Date de publication:
01 03 2021
01 03 2021
Historique:
received:
08
10
2020
revised:
21
11
2020
accepted:
14
12
2020
pubmed:
19
12
2020
medline:
11
2
2022
entrez:
18
12
2020
Statut:
ppublish
Résumé
Premenopausal women diagnosed with estrogen receptor (ER)-positive breast cancer are prescribed 5-10 years of endocrine therapy to prevent or delay recurrence. In this study, we evaluated the association between early discontinuation of endocrine therapy and breast cancer recurrence in a cohort of premenopausal women. We identified 4,503 patients with premenopausal ER-positive breast cancer who initiated adjuvant endocrine therapy and were registered in the Danish Breast Cancer Group clinical database (2002-2011). Women were excluded if they had a recurrence or were lost to follow-up less than 1.5 years after breast cancer surgery. Endocrine therapy was considered complete if the patient received at least 4.5 years of treatment or discontinued medication less than 6 months before recurrence. Exposure status was updated annually and modeled as a time-dependent variable. We accounted for baseline and time-varying confounders via time-varying weights, which we calculated from multivariable logistic regression models, and included in regression models to estimate HRs and 95% confidence intervals (CIs) associating early discontinuation with recurrence. Over the study follow-up, 1,001 (22%) women discontinued endocrine therapy. We observed 202 (20%) recurrences among those who discontinued endocrine therapy, and 388 (11%) among those who completed the recommended treatment. The multivariable-adjusted estimated rate of recurrence was higher in women who discontinued endocrine therapy relative to those who completed their treatment (hazard ratio, 1.67; 95% CI, 1.25-2.14). These results highlight the importance of clinical follow-up and behavioral interventions that support persistence of adjuvant endocrine therapy to prevent breast cancer recurrence.
Identifiants
pubmed: 33334905
pii: 1078-0432.CCR-20-3974
doi: 10.1158/1078-0432.CCR-20-3974
pmc: PMC7925421
mid: NIHMS1656557
doi:
Substances chimiques
Antineoplastic Agents, Hormonal
0
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1421-1428Subventions
Organisme : NCI NIH HHS
ID : F31 CA239566
Pays : United States
Organisme : NIGMS NIH HHS
ID : P20 GM103644
Pays : United States
Organisme : NCI NIH HHS
ID : R01 CA166825
Pays : United States
Organisme : NCATS NIH HHS
ID : TL1 TR002540
Pays : United States
Informations de copyright
©2020 American Association for Cancer Research.
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