期刊
CLINICAL CANCER RESEARCH
卷 27, 期 5, 页码 1421-1428出版社
AMER ASSOC CANCER RESEARCH
DOI: 10.1158/1078-0432.CCR-20-3974
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资金
- U.S. NCI [R01CA166825, F31CA239566]
- Lundbeck Foundation [R167-2013-15861]
- Novo Nordisk Foundation [NNF19OC0058710]
- National Institute of General Medical Sciences [P20GM103644]
This study evaluated the association between early discontinuation of endocrine therapy and breast cancer recurrence in premenopausal women. The results showed a higher rate of recurrence in women who discontinued endocrine therapy compared to those who completed the recommended treatment. These findings emphasize the importance of clinical follow-up and behavioral interventions to support the persistence of adjuvant endocrine therapy in preventing breast cancer recurrence.
Purpose: 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. Experimental Design: 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. Results: 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). Conclusions: These results highlight the importance of clinical follow-up and behavioral interventions that support persistence of adjuvant endocrine therapy to prevent breast cancer recurrence.
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