Prognostic impact of adjuvant endocrine therapy for estrogen receptor-positive and HER2-negative T1a/bN0M0 breast cancer

Sasada, Shinsuke; Kondo, Naoto; Hashimoto, Hiroya; Takahashi, Yuko; Terata, Kaori; Kida, Kumiko; Sagara, Yasuaki; Ueno, Takayuki; Anan, Keisei; Suto, Akihiko; Kanbayashi, Chizuko; Takahashi, Mina; Nakamura, Rikiya; Ishiba, Toshiyuki; Tsuneizumi, Michiko; Nishimura, Seiichiro; Naito, Yoichi; Hara, Fumikata; Shien, Tadahiko; Iwata, Hiroji

doi:10.1007/s10549-023-07097-6

Permalink : https://ousar.lib.okayama-u.ac.jp/66982

ID	66982
FullText URL	fulltext.pdf 1.92 MB
Author	Sasada, Shinsuke Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University Kondo, Naoto Department of Breast Surgery, Nagoya City University Graduate School of Medical Sciences Hashimoto, Hiroya Core Laboratory, Nagoya City University Graduate School of Medical Sciences Takahashi, Yuko Department of Breast and Endocrine Surgery, Okayama University Hospital Terata, Kaori Department of Breast and Endocrine Surgery, Akita University Hospital Kida, Kumiko Department of Breast Surgical Oncology, St. Luke’s International Hospital Sagara, Yasuaki Department of Breast and Thyroid Surgical Oncology, Social medical corporation Hakuaikai, Sagara Hospital Ueno, Takayuki Breast Oncology Center, The Cancer Institute Hospital of Japanese Foundation for Cancer Research Anan, Keisei Department of Surgery, Kitakyushu Municipal Medical Center Suto, Akihiko Department of Breast Surgery, National Cancer Center Hospital Kanbayashi, Chizuko Department of Breast Oncology, Niigata Cancer Center Hospital Takahashi, Mina Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center Nakamura, Rikiya Department of Breast Surgery, Chiba Cancer Center Ishiba, Toshiyuki Department of Breast Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital Tsuneizumi, Michiko Department of Breast Surgery, Shizuoka General Hospital Nishimura, Seiichiro Department of Breast Surgery, Shizuoka Cancer Center Hospital Naito, Yoichi Department of General Internal Medicine, National Cancer Center Hospital East Hara, Fumikata Breast Oncology Center, The Cancer Institute Hospital of Japanese Foundation for Cancer Research Shien, Tadahiko Department of Breast and Endocrine Surgery, Okayama University Hospital ORCID Kaken ID publons researchmap Iwata, Hiroji Department of Breast Oncology, Aichi Cancer Center Hospital
Abstract	Purpose Mammography screening has increased the detection of subcentimeter breast cancers. The prognosis for estrogen receptor (ER)-positive and human epidermal growth factor receptor 2 (HER2)-negative T1a/bN0M0 breast cancers is excellent; however, the necessity of adjuvant endocrine therapy (ET) is uncertain. Methods We evaluated the effectiveness of adjuvant ET in patients with ER-positive and HER2-negative T1a/bN0M0 breast cancer who underwent surgery from 2008 to 2012. Standard ET was administrated after surgery. The primary endpoint was the cumulative incidence of distant metastasis. All statistical tests were 2-sided. Results Adjuvant ET was administered to 3991 (83%) of the 4758 eligible patients (1202 T1a [25.3%] and 3556 T1b [74.7%], diseases). The median follow-up period was 9.2 years. The 9-year cumulative incidence of distant metastasis was 1.5% with ET and 2.6% without ET (adjusted subdistribution hazard ratio [sHR], 0.54; 95% CI, 0.32–0.93). In multivariate analysis, the independent risk factors for distant metastasis were no history of ET, mastectomy, high-grade, and lymphatic invasion. The 9-year overall survival was 97.0% and 94.4% with and without ET, respectively (adjusted HR, 0.57; 95% CI, 0.39–0.83). In addition, adjuvant ET reduced the incidence of ipsilateral and contralateral breast cancer (9-year rates; 1.1% vs. 6.9%; sHR, 0.17, and 1.9% vs. 5.2%; sHR, 0.33). Conclusions The prognosis was favorable in patients with ER-positive and HER2-negative T1a/bN0M0 breast cancer. Furthermore, adjuvant ET reduced the incidence of distant metastasis with minimal absolute risk difference. These findings support considering the omission of adjuvant ET, especially for patients with low-grade and no lymphatic invasion disease.
Keywords	Breast cancer T1a/b Endocrine therapy Estrogen receptor Prognosis
Note	The version of record of this article, first published in Breast Cancer Research and Treatment, is available online at Publisher’s website: http://dx.doi.org/10.1007/s10549-023-07097-6
Published Date	2023-09-09
Publication Title	Breast Cancer Research and Treatment
Volume	volume202
Issue	issue3
Publisher	Springer Science and Business Media LLC
Start Page	473
End Page	483
ISSN	0167-6806
NCID	AA10623184
Content Type	Journal Article
language	English
OAI-PMH Set	岡山大学
Copyright Holders	© The Author(s) 2023
File Version	publisher
PubMed ID	37688665
DOI	10.1007/s10549-023-07097-6
Web of Science KeyUT	001065105700004
Related Url	isVersionOf https://doi.org/10.1007/s10549-023-07097-6
License	http://creativecommons.org/licenses/by/4.0/
Citation	Sasada, S., Kondo, N., Hashimoto, H. et al. Prognostic impact of adjuvant endocrine therapy for estrogen receptor-positive and HER2-negative T1a/bN0M0 breast cancer. Breast Cancer Res Treat 202, 473–483 (2023). https://doi.org/10.1007/s10549-023-07097-6
Funder Name	Ministry of Health, Labour and Welfare Japan Agency for Medical Research and Development
助成番号	23-A-19 26-A-4 29-A-3 2020-J-3 JP20-22ck0106593