ArticleAnnals of surgical oncology2021
Effects of Adjuvant Endocrine Therapy Adherence and Radiation on Recurrence and Survival Among Older Women with Early-Stage Breast Cancer.
Article in Annals of surgical oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Frequency of use and characterization of frailty assessments in observational studies on older women with breast cancer: a systematic review.BMC geriatrics · 2024Pooled it
- Ninety Days of Preoperative Endocrine Therapy Informs Patient and Physician Preference for Radiation Therapy: Primary Results from the Preoperative Window of Endocrine Therapy to Inform Radiation Therapy Decisions (POWER) Trial.Annals of surgical oncology · 2025Trial
- A Preoperative Window-of-Opportunity Study of Oral SERD, Imlunestrant, in Newly Diagnosed ER-Positive, HER2-Negative Early Breast Cancer: Results from the EMBER-2 Study.Clinical cancer research : an official journal of the American Association for Cancer Research · 2024Trial
- Omitting radiotherapy in LUMINA-like breast cancer after breast conserving surgery: 10-year results of a population-based cohort study.The oncologist · 2025Article
- ASO Author Reflections: Ninety Days of Preoperative Endocrine Therapy Informs Patient and Physician Preference for Radiation Therapy.Annals of surgical oncology · 2025Article
- Group-Based Trajectory Modeling to Identify Patterns and Predictors of Adherence to Oral Endocrine Therapies in Underserved Population of Greater Houston Area.Patient preference and adherence · 2025Article
- Overtreatment and Undertreatment of Early-Stage Breast Cancer in Older Women: Evaluating the POWER Trial.The Journal of surgical research · 2024Article
- Article
- Machine learning in metastatic cancer research: Potentials, possibilities, and prospects.Computational and structural biotechnology journal · 2023Review
- Endocrine therapy initiation among women with stage I-III invasive, hormone receptor-positive breast cancer from 2001-2016.Breast cancer research and treatment · 2022Article
- Personalising therapy for early-stage oestrogen receptor-positive breast cancer in older women.The lancet. Healthy longevity · 2022Review
- Association of Patient Experience of Care and Radiation Therapy Initiation Among Women With Early-Stage Breast Cancer.Practical radiation oncologyArticle
Corrections and comments
- Commented on by
- Erratum issued
Authors and funding
6 authors.
Funding
Abstract
backgroundThe Cancer and Leukemia Group-B 9343 (CALGB 9343) trial demonstrated that women aged ≥ 70 years with early-stage breast cancer can safely omit radiation therapy (RT) and be treated with breast-conserving surgery (BCS) and adjuvant endocrine therapy (AET) alone. AET adherence is low, leaving an undertreated cohort who may be at increased risk of recurrence and death. We hypothesized that AET adherence and adjuvant treatment choice impact recurrence and survival among CALGB 9343 eligible women. PATIENTS AND
methodsSEER-Medicare was used to identify CALGB 9343 eligible women who underwent BCS between 2007 and 2016. Medicare claims were used to identify AET use, and the proportion of days covered by AET was used to categorize adherent (PDC ≥ 0.80) versus nonadherent patients (PDC < 0.80). Recurrence-free, cancer-specific, and overall survival were assessed using Cox proportional hazards models.
resultsIn total, 10,719 women were identified, of whom 780 (7.3%) underwent BCS alone, 1490 (13.9%) underwent BCS + RT, 1663 (15.5%) underwent BCS + AET, and 6786 (63.3%) had BCS + RT + AET. Among women treated with BCS + AET, adherent patients had lower recurrence than did nonadherent patients (HR = 0.65, 95% CI: 0.50-0.85). With respect to adjuvant treatment combinations, there was no recurrence difference between the BCS + RT + AET group and BCS + AET group (HR = 0.81, 95% CI: 0.54-1.21). There was equivalent cancer-specific but worse overall survival in the BCS + AET group versus the BCS + AET + RT group.
conclusionsWhile BCS + RT + AET may represent overtreatment for some, AET nonadherent women who omit RT are at risk for worse outcomes. Treatment decisions regarding RT omission should be tailored to the individual patient, taking into consideration the chances of AET nonadherence and the patients' own risk tolerance.
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