Marc Debled1, Gaël Auxepaules2, Christine Tunon de Lara2, Delphine Garbay3, Véronique Brouste4, Emmanuel Bussières2, Louis Mauriac3, Gaëtan MacGrogan5. 1. Department of Medical Oncology, Institut Bergonié, 229 cours de l'Argonne, F-33000 Bordeaux, France. Electronic address: m.debled@bordeaux.unicancer.fr. 2. Department of Surgery, Institut Bergonié, 229 cours de l'Argonne, F-33000 Bordeaux, France. 3. Department of Medical Oncology, Institut Bergonié, 229 cours de l'Argonne, F-33000 Bordeaux, France. 4. Clinical and Epidemiological Research Unit, Institut Bergonié, 229 cours de l'Argonne, F-33000 Bordeaux, France. 5. Department of Pathology, Institut Bergonié, 229 cours de l'Argonne, F-33000 Bordeaux, France.
Abstract
BACKGROUND: To examine outcomes of neoadjuvant endocrine therapy in daily practice to inform decision making. METHODS: We retrospectively selected 204 patients who received neoadjuvant endocrine therapy with T2 (≥30 mm) or T3 tumors, examining subsequent breast-sparing surgery and long-term outcomes. RESULTS: Neoadjuvant endocrine therapy was administered for 7.3 months (median) and breast-sparing surgery was achievable in 53% of patients. Smaller initial tumor size and modified version of the Scarff-Bloom and Richardson grades 1 to 2 were associated with breast-sparing surgery. Disease progression during treatment was 6.9%; actuarial risk of local relapse was 3% at 5 years and 15% at 10 years. Five- and 10-year metastasis relapse-free survival was 78% and 63%, respectively. Grade 3, negative progesterone receptors, and absence or slow response to neoadjuvant therapy were associated prognostic factors. CONCLUSION: These daily practice data provide important information about feasibility, efficacy, and long-term results of neoadjuvant endocrine therapy and can be used to inform patients for decision making between mastectomy and endocrine induction therapy.
BACKGROUND: To examine outcomes of neoadjuvant endocrine therapy in daily practice to inform decision making. METHODS: We retrospectively selected 204 patients who received neoadjuvant endocrine therapy with T2 (≥30 mm) or T3 tumors, examining subsequent breast-sparing surgery and long-term outcomes. RESULTS: Neoadjuvant endocrine therapy was administered for 7.3 months (median) and breast-sparing surgery was achievable in 53% of patients. Smaller initial tumor size and modified version of the Scarff-Bloom and Richardson grades 1 to 2 were associated with breast-sparing surgery. Disease progression during treatment was 6.9%; actuarial risk of local relapse was 3% at 5 years and 15% at 10 years. Five- and 10-year metastasis relapse-free survival was 78% and 63%, respectively. Grade 3, negative progesterone receptors, and absence or slow response to neoadjuvant therapy were associated prognostic factors. CONCLUSION: These daily practice data provide important information about feasibility, efficacy, and long-term results of neoadjuvant endocrine therapy and can be used to inform patients for decision making between mastectomy and endocrine induction therapy.