| Added by | standudu |
|---|---|
| Group name | EquipeCTCS |
| Item Type | Journal Article |
| Title | Therapeutic escalation - De-escalation: Data from 15.508 early breast cancer treated with upfront surgery and sentinel lymph node biopsy (SLNB) |
| Creator | Houvenaeghel et al. |
| Author | Gilles Houvenaeghel |
| Author | Eric Lambaudie |
| Author | Monique Cohen |
| Author | Jean-Marc Classe |
| Author | Fabien Reyal |
| Author | Jean-Rémy Garbay |
| Author | Sylvia Giard |
| Author | Nicolas Chopin |
| Author | Alejandra Martinez |
| Author | Roman Rouzier |
| Author | Emile Daraï |
| Author | Pierre Emmanuel Colombo |
| Author | Charles Coutant |
| Author | Pierre Gimbergues |
| Author | Pierre Azuar |
| Author | Richard Villet |
| Author | Christine Tunon de Lara |
| Author | Emmanuel Barranger |
| Author | Laura Sabiani |
| Author | Anthony Goncalves |
| Abstract | INTRODUCTION: The aim of this study was to examine changes in therapeutic practices for early breast cancer T0-2 N0 managed by upfront surgery and SLNB. POPULATION: Between 1999 and 2012, 15.508 patients were treated. Four periods were determined: 1999-2003, 2004-2006, 2007-2009 and > 2009. Five tumor subtypes were defined according to hormonal receptors (HR) and Her2: Luminal A (HR + Her2- Grade 1-2), Her2 (Her2+ HR-), Triple-negative (HR- Her2-), Luminal B Her2- (HR + Her2- Grade 3), Luminal B Her2+ (HR + HER2+). METHODS: Rates of axillary lymph node dissection (ALND), adjuvant chemotherapy ± trastuzumab, endocrine treatment, mastectomy and post mastectomy radiotherapy (PMRT) were analyzed according to treatment periods with univariate and multivariate analysis. Overall and disease-free survivals were analyzed according to treatment periods adjusted for HR and then for tumor subtypes. RESULTS: Rates of ALND, adjuvant chemotherapy and endocrine treatment varied significantly according to treatment periods, for HR positive and negative tumors. ALND rate decreased for all tumor subtypes with a decrease of adjuvant chemotherapy rate for Luminal A tumors and an increase for Luminal B Her2+ and Her2-tumors. Endocrine treatment rate decreased for Luminal A and increased for Luminal B Her2+ tumors. In multivariate analysis, these modifications with time remained significant. Mastectomy and PMRT rates increased. In multivariate analysis, overall and disease-free survivals increased during successive periods. CONCLUSION: A global therapeutic de-escalation in ALND and adjuvant systemic treatment, combined with an actual escalation in some specific subsets was demonstrated, but without negative impact on survival. |
| Publication | Breast (Edinburgh, Scotland) |
| Volume | 34 |
| Pages | 24-33 |
| Date | Aug 2017 |
| Journal Abbr | Breast |
| Language | eng |
| DOI | 10.1016/j.breast.2017.04.008 |
| ISSN | 1532-3080 |
| Short Title | Therapeutic escalation - De-escalation |
| Library Catalog | PubMed |
| Extra | PMID: 28475932 |
| Tags | Adult, Aged, Antineoplastic Agents, Hormonal, Antineoplastic Agents, Immunological, Axilla, Breast Neoplasms, Chemotherapy, Chemotherapy, Adjuvant, clinic, De-escalation, Disease-Free Survival, Female, Hormonotherapy, Humans, Lymph Node Excision, Lymphatic Metastasis, Mastectomy, Middle Aged, Neoplasm Staging, Radiotherapy, Adjuvant, Receptor, ErbB-2, Receptors, Estrogen, Receptors, Progesterone, Retrospective Studies, Sentinel Lymph Node Biopsy, Sentinel node, Surgery, Survival Rate, Trastuzumab |
| Date Added | 2018/11/14 - 15:24:24 |
| Date Modified | 2019/05/14 - 18:56:12 |
| Notes and Attachments | PubMed entry (Attachment) |
Institut de Recherche en Cancérologie de
