Lucia Mangone1, Pamela Mancuso1, Giovanna Tagliabue2, Rosa Angela Filiberti3, Giuliano Carrozzi4, Silvia Iacovacci5, Walter Mazzucco6, Rosario Tumino7, Pamela Minicozzi2, Milena Sant2, Paolo Giorgi Rossi1. 1. Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS Reggio Emilia, Reggio Emilia, Italy. 2. Analytical Epidemiology and Health Impact Unit, Research Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. 3. RTR Liguria, IRCCS AOU SM-IST, Liguria, Italy. 4. Department of Public Health, Local Health Unit, Modena, Italy. 5. Latina Cancer Registry, Lazio, Italy. 6. Department of Health Promotion and of Maternal and Childhood Sciences, University of Palermo, Palermo, Italy. 7. Histopathology Department and Cancer Registry, Provincial Health Authority, ASP Ragusa, Ragusa, Italy.
Abstract
OBJECTIVE: To evaluate the frequency of neoadjuvant therapy (NT) in women with stage I-III breast cancer in Italy and whether it is influenced by biological characteristics, screening history, and geographic area. METHODS: Data from the High Resolution Study conducted in 7 Italian cancer registries were used; they are a representative sample of incident cancers in the study period (2009-2013). Included were 3546 women aged <85 years (groups <50, 50-69, 70-64, and 75+) with stage I-III breast cancer at diagnosis who underwent surgery. Women were classified as receiving NT if they received chemotherapy, target therapy, and/or hormone therapy before the first surgical treatment. Logistic models were built to test the association with biological and contextual variables. RESULTS: Only 8.2% of women (290 cases) underwent NT; the treatment decreases with increasing age (14.5% in age <50 and 2.2% in age 75+), is more frequent in women with negative receptors (14.8%), HER2-positive (15.7%), and triple-negative (15.6%). The multivariable analysis showed the probability of receiving NT is higher in stage III (odds ratio [OR] 3.83; 95% confidence interval [CI] 2.83-5.18), luminal B (OR 1.87; 95% CI 1.27-2.76), triple-negatives (OR 1.88; 95% CI 1.15-3.08), and in symptomatic cancers (OR 1.98; 95% CI 1.13-3.48). Use of NT varied among geographic areas: Reggio Emilia had the highest rates (OR 2.29; 95% CI 1.37-3.82) while Palermo had the lowest (OR 0.41; 95% CI 0.24-0.68). CONCLUSIONS: The use of NT in Italy is limited and variable. There are no signs of greater use in hospitals with more advanced care.
OBJECTIVE: To evaluate the frequency of neoadjuvant therapy (NT) in women with stage I-III breast cancer in Italy and whether it is influenced by biological characteristics, screening history, and geographic area. METHODS: Data from the High Resolution Study conducted in 7 Italian cancer registries were used; they are a representative sample of incident cancers in the study period (2009-2013). Included were 3546 women aged <85 years (groups <50, 50-69, 70-64, and 75+) with stage I-III breast cancer at diagnosis who underwent surgery. Women were classified as receiving NT if they received chemotherapy, target therapy, and/or hormone therapy before the first surgical treatment. Logistic models were built to test the association with biological and contextual variables. RESULTS: Only 8.2% of women (290 cases) underwent NT; the treatment decreases with increasing age (14.5% in age <50 and 2.2% in age 75+), is more frequent in women with negative receptors (14.8%), HER2-positive (15.7%), and triple-negative (15.6%). The multivariable analysis showed the probability of receiving NT is higher in stage III (odds ratio [OR] 3.83; 95% confidence interval [CI] 2.83-5.18), luminal B (OR 1.87; 95% CI 1.27-2.76), triple-negatives (OR 1.88; 95% CI 1.15-3.08), and in symptomatic cancers (OR 1.98; 95% CI 1.13-3.48). Use of NT varied among geographic areas: Reggio Emilia had the highest rates (OR 2.29; 95% CI 1.37-3.82) while Palermo had the lowest (OR 0.41; 95% CI 0.24-0.68). CONCLUSIONS: The use of NT in Italy is limited and variable. There are no signs of greater use in hospitals with more advanced care.
Entities:
Keywords:
Breast cancer; multidisciplinary; neoadjuvant therapy