Investigating the effectiveness of adjuvant therapy for patients with hormone receptor-positive ductal carcinoma in situ

This study compared the recurrence risk of single versus dual adjuvant radiotherapy (RT) and hormonal therapy (HT) following breast-conserving surgery (BCS) in patients with hormone receptor-positive ductal carcinoma in situ (DCIS). This retrospective cohort study used the Taiwan Cancer Registry dat...

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Bibliographic Details
Published in:PloS one 2022-01, Vol.17 (1), p.e0262934
Main Authors: Tsai, Chi-Jui, Huang, Ho-Yin, Chen, Fang-Ming, Yang, Yi-Hsin, Chen, Li-Chia, Hsieh, Kun-Pin
Format: Article
Language:English
Subjects:
Adjuvant therapy
Adjuvant treatment
Adult
Age
Breast
Breast cancer
Breast Neoplasms - mortality
Breast Neoplasms - therapy
Cancer
Cancer therapies
Carcinoma, Ductal
Carcinoma, Ductal, Breast - mortality
Carcinoma, Ductal, Breast - therapy
Codes
Confidence intervals
Databases, Factual
Disease-Free Survival
Drug therapy
Family medical history
Female
Follow-Up Studies
Hormone Replacement Therapy
Hospitals
Humans
Mammography
Medical research
Medical screening
Medicine
Medicine and Health Sciences
Menstruation
Middle Aged
Mortality
Patient outcomes
Patients
Pharmacy
Population
Radiation
Radiation therapy
Radiotherapy
Receptors
Registries
Retrospective Studies
Risk
Social Sciences
Surgery
Survival
Survival Rate
Taiwan - epidemiology
Womens health
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Summary:This study compared the recurrence risk of single versus dual adjuvant radiotherapy (RT) and hormonal therapy (HT) following breast-conserving surgery (BCS) in patients with hormone receptor-positive ductal carcinoma in situ (DCIS). This retrospective cohort study used the Taiwan Cancer Registry database linking to the Taiwan National Health Insurance data from 2011 to 2016. We compared the recurrence risk between BCS-based regimens in Cox regressions and presented as adjusted hazard ratio (HR) and 95% confidence interval (95%CI). The 1,836 study cohort with a low-to-intermediate risk of recurrence was grouped into BCS alone (6.1%), BCS+RT (6.2%), BCS+HT (23.4%) and BCS+HT+RT (64.3%) according to the initial treatments. During the follow-up (median: 3.3 years), the highest 5-year recurrence-free survival rate was in BCS+RT (94.1%) group and followed by BCS+HT+RT (92.8%), BCS+HT (87.4%) and BCS alone (84.9%). Of the single adjuvant therapies, RT was more effective than HT. Both BCS+HT (HR: 1.52, 95%CI: 0.99-2.35) and BCS+RT (HR: 1.10, 95%CI: 0.50-2.41) did not significantly increase recurrence risk comparing against the BCS+HT+RT group. Single adjuvant demonstrated a similar subsequent recurrence risk with dual adjuvant. This study supports the proposition to de-escalate adjuvant treatments in patients with low-to-intermediate risk of DCIS recurrence.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0262934