ArticleAnnals of surgical oncology2022
Impact of Endocrine Therapy Adherence on Outcomes in Elderly Women with Early-Stage Breast Cancer Undergoing Lumpectomy Without Radiotherapy.
Article in Annals of surgical oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 15 citations in OpenAlex.
- Extended endocrine therapy use and decision making after breast cancer diagnosis.Journal of the National Cancer Institute · 2025Article
- Downstream Effects of Omission of Axillary Surgery in Older Adults with Early-Stage HR+/HER2- Breast Cancer.Annals of surgical oncology · 2025Article
- Adjuvant Radiation vs Endocrine Therapy After Lumpectomy for Early-Stage Breast Cancer in Older Women: Analysis of Real-World Survival Outcomes.Annals of surgical oncology · 2025Article
- Article
- Unfavorable Prognostic Impact of HER2 2+/FISH-Negativity in Older Patients with HER2-Negative and High-Risk Breast Cancer.Breast cancer (Dove Medical Press) · 2024Article
- Article
- Recent Advances in Optimizing Radiation Therapy Decisions in Early Invasive Breast Cancer.Cancers · 2023Review
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
backgroundNational Comprehensive Center Network guidelines recommend radiotherapy (RT) omission in women age ≥ 70 years with estrogen receptor-positive (ER+), cN0, T1 tumors post-lumpectomy if they receive endocrine therapy (ET). However, little is known about the impact of poor adherence on locoregional recurrence (LRR) in elderly women forgoing RT.
methodsWomen age ≥ 70 years with pT1-2 ER+ breast cancer undergoing lumpectomy without RT from 2004 to 2019 were identified from a prospectively maintained database. ET adherence, calculated as treatment duration over follow-up time up to 5 years, was determined by chart review. We compared clinicopathologic characteristics and rates of LRR between women with high adherence (≥ 80%), low adherence (< 80%), and no ET.
resultsOf 968 women (27 bilateral cancers), adherence was high in 676 (70%) and low in 162 (17%); 130 (13%) took no ET. Younger age and use of aromatase inhibitor were associated with high adherence. On multivariable analysis, tumor size (hazard ratio [HR] 1.67, 95% confidence interval [CI] 1.03-2.68, p = 0.04) and high adherence (HR 0.13, 95% CI 0.07-0.26, p < 0.001) were significantly associated with LRR. At 53 months median follow-up, the 5-year rate of LRR was 3.1% (95% CI 2.4-3.9%) with high adherence, 14.7% (95% CI 11.7-17.7%) with low adherence, and 17.9% (95% CI 13.9-21.8%) with no ET (p < 0.01).
conclusionsAlthough adherence to ET was high overall, in the 30% of women with low adherence or no ET, LRR rates were significantly increased. Counseling regarding the distinct toxicities of ET and RT can help patients choose the therapy to which they will likely adhere to.
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