281P - For which PT1A, BN0M0 hormone responsive invasive breast carcinomas could endocrine therapy be avoided?
|Date||01 October 2012|
|Event||ESMO Congress 2012|
|Session||Poster presentation III|
|Topics|| Breast Cancer, Early Stage
C. Perrin1, J. Edeline2, J. Leseur3, V. Lavoué4, P. Tas5, H. Mesbah6, C. Lefeuvre-Plesse7, D. Gedouin7, F. Penault-Llorca8, P. Kerbrat9
Overtreatment is a daily concern in adjuvant setting for invasive breast carcinoma. Although chemotherapy is the most controversial issue, endocrine therapies must also be discussed.Methods
In this monocentric retrospective study, we analysed results of patients treated for hormone responsive invasive pT1a,bN0M0 breast cancer, focusing on the population without adjuvant endocrine treatment. Women with previous history of invasive carcinoma were excluded.Results
In our institution, 382 patients with hormone responsive breast invasive pT1a,bN0M0 carcinoma were treated between 1997 and 2007. Local treatment involved either mastectomy or partial breast surgery followed by breast radiotherapy. After multidisciplinary discussion, among the 382 patients, 162 patients (42 %) did not receive any adjuvant endocrine treatment. Comparatively to the group treated with endocrine therapy, these patients had significantly more grade I tumors (81.4 % versus 47.2 %, p< 0.0001) and Ki67 < 14% (89.6% versus 72.4%, p < 0.0001). In patients not treated with endocrine therapy, after a mean follow-up of 7.1 years, 5 years-disease free survival (DFS) was 93% and 5 years-distant disease free survival was 98.7%. Remarkably, 5 years-DFS was particularly favourable for patients older than 50 years old (97.1% versus 82.1% for age < 50 years old, p = 0.0002) and for grade I carcinomas (97.3% versus 76.7% for grade II-III, p= 0.0005). Only one metastatic recurrence occurred after 10 years in the grade I group.Conclusion
This series of patients treated without adjuvant endocrine therapies raises the issue of avoiding anti tumor endocrine therapy in patients with hormone responsive pT1a,bN0M0, age> 50 years and grade I tumors.Disclosure
All authors have declared no conflicts of interest.