PURPOSE: To describe the frequency of chemotherapy use for hormone receptor (HR)-positive, lymph node (LN)-negative breast cancer from 1997 to 2004 at eight National Comprehensive Cancer Network institutions, to explore whether chemotherapy use varied over time and between institutions, and to identify factors associated with the decision to forego chemotherapy. PATIENTS AND METHODS: Among women younger than age 70 years with HR-positive, LN-negative breast cancer measuring more than 1 cm, we analyzed the frequency of chemotherapy use on a yearly basis. A multivariable logistic regression model assessed the relationship between receipt of chemotherapy and year of diagnosis, institution, tumor features, and patient characteristics. Interaction terms were added to the model, and stratified analyses were conducted to further explore the determinants of chemotherapy use. RESULTS: Fifty-five percent of 3,190 women received chemotherapy. Chemotherapy use was less common for patients with 1.1- to 2-cm tumors than for patients tumors greater 2 cm (47% v 87%, respectively; P < .01) and for women age 60 to 69 years versus women younger than age 50 years (24% v 76%, respectively; P < .01). On multivariable analysis, predictors independently associated with receiving chemotherapy included larger tumor size, higher grade, human epidermal growth factor receptor 2 overexpression, younger age, and institution (P < .01 for all). Institutions exhibited dramatically different rates of chemotherapy use (from 46% to 65%) and patterns of change in chemotherapy use over time (from a 79% relative increase to a 22% relative decrease). CONCLUSION: Although institutions seemed to agree that not all women with HR-positive, LN-negative breast cancer need chemotherapy, there did not seem to be consensus regarding which women should get chemotherapy. Only prospective randomized controlled trials will conclusively establish which subtypes of HR-positive, LN-negative breast cancer benefit from chemotherapy.
PURPOSE: To describe the frequency of chemotherapy use for hormone receptor (HR)-positive, lymph node (LN)-negative breast cancer from 1997 to 2004 at eight National Comprehensive Cancer Network institutions, to explore whether chemotherapy use varied over time and between institutions, and to identify factors associated with the decision to forego chemotherapy. PATIENTS AND METHODS: Among women younger than age 70 years with HR-positive, LN-negative breast cancer measuring more than 1 cm, we analyzed the frequency of chemotherapy use on a yearly basis. A multivariable logistic regression model assessed the relationship between receipt of chemotherapy and year of diagnosis, institution, tumor features, and patient characteristics. Interaction terms were added to the model, and stratified analyses were conducted to further explore the determinants of chemotherapy use. RESULTS: Fifty-five percent of 3,190 women received chemotherapy. Chemotherapy use was less common for patients with 1.1- to 2-cm tumors than for patientstumors greater 2 cm (47% v 87%, respectively; P < .01) and for women age 60 to 69 years versus women younger than age 50 years (24% v 76%, respectively; P < .01). On multivariable analysis, predictors independently associated with receiving chemotherapy included larger tumor size, higher grade, humanepidermal growth factor receptor 2 overexpression, younger age, and institution (P < .01 for all). Institutions exhibited dramatically different rates of chemotherapy use (from 46% to 65%) and patterns of change in chemotherapy use over time (from a 79% relative increase to a 22% relative decrease). CONCLUSION: Although institutions seemed to agree that not all women with HR-positive, LN-negative breast cancer need chemotherapy, there did not seem to be consensus regarding which women should get chemotherapy. Only prospective randomized controlled trials will conclusively establish which subtypes of HR-positive, LN-negative breast cancer benefit from chemotherapy.
Authors: B Fisher; J Dignam; N Wolmark; A DeCillis; B Emir; D L Wickerham; J Bryant; N V Dimitrov; N Abramson; J N Atkins; H Shibata; L Deschenes; R G Margolese Journal: J Natl Cancer Inst Date: 1997-11-19 Impact factor: 13.506
Authors: Michael J Hassett; Melissa E Hughes; Joyce C Niland; Rebecca Ottesen; Stephen B Edge; Michael A Bookman; Robert W Carlson; Richard L Theriault; Jane C Weeks Journal: Med Care Date: 2008-08 Impact factor: 2.983
Authors: Stephen B Edge; Joyce C Niland; Michael A Bookman; Richard L Theriault; Rebecca Ottesen; Eva Lepisto; Jane C Weeks Journal: J Natl Cancer Inst Date: 2003-10-15 Impact factor: 13.506
Authors: Xianglin L Du; Charles R Key; Cynthia Osborne; Jonathan D Mahnken; James S Goodwin Journal: Ann Intern Med Date: 2003-01-21 Impact factor: 25.391
Authors: Mauro Palazzi; Dolores De Tomasi; Caterina D'Affronto; Antonella Richetti; Maria Carla Valli; Sofia Meregalli; Diego Asnaghi; Virginia Arienti; Dario Cavallini; Renato Pradella; Ines Cafaro; Gianni Baroncelli; Innocenzo Di Lorenzo; Antonio De Agostini; Giovanni Parrinello; Filippo Bertoni Journal: Tumori Date: 2002 Nov-Dec
Authors: Bradley M Turner; Kristin A Skinner; Ping Tang; Mary C Jackson; Nyrie Soukiazian; Michelle Shayne; Alissa Huston; Marilyn Ling; David G Hicks Journal: Mod Pathol Date: 2015-05-01 Impact factor: 7.842
Authors: Allison W Kurian; Irina Bondarenko; Reshma Jagsi; Christopher R Friese; M Chandler McLeod; Sarah T Hawley; Ann S Hamilton; Kevin C Ward; Timothy P Hofer; Steven J Katz Journal: J Natl Cancer Inst Date: 2018-05-01 Impact factor: 13.506
Authors: Laura Dominici; Julie Najita; Melissa Hughes; Joyce Niland; Paul Marcom; Yu-Ning Wong; Bradford Carter; Sara Javid; Stephen Edge; Harold Burstein; Mehra Golshan Journal: Breast Cancer Res Treat Date: 2011-06-29 Impact factor: 4.872
Authors: Jennifer J Griggs; Sarah T Hawley; John J Graff; Ann S Hamilton; Reshma Jagsi; Nancy K Janz; Mahasin S Mujahid; Christopher R Friese; Barbara Salem; Paul H Abrahamse; Steven J Katz Journal: J Clin Oncol Date: 2012-08-06 Impact factor: 44.544
Authors: Michael J Hassett; Samuel M Silver; Melissa E Hughes; Douglas W Blayney; Stephen B Edge; James G Herman; Clifford A Hudis; P Kelly Marcom; Jane E Pettinga; David Share; Richard Theriault; Yu-Ning Wong; Jonathan L Vandergrift; Joyce C Niland; Jane C Weeks Journal: J Clin Oncol Date: 2012-05-14 Impact factor: 44.544