207P - Survival impact of adjuvant chemotherapy in screening breast cancer

Date 10 October 2016
Event ESMO 2016 Congress
Session Poster display
Topics Breast Cancer
Presenter Irene Zarcos Pedrinaci
Citation Annals of Oncology (2016) 27 (6): 43-67. 10.1093/annonc/mdw364
Authors I. Zarcos Pedrinaci1, A. Romero2, J. Louro2, M. Banqué2, M. Vernet3, L. Serrano4, R. Funez5, F. Medina6, D. Perez7, A. Rueda8, M. Sala2, M. Redondo9
  • 1Medical Oncology, A.S Hospital Costa del Sol, 29603 - Malaga/ES
  • 2Epidemiology, University Hospital del Mar, Barcelona/ES
  • 3Surgery, University Hospital del Mar, Barcelona/ES
  • 4Pathology, University Hospital del Mar, Barcelona/ES
  • 5Pathology, A.S Hospital Costa del Sol, 29603 - Malaga/ES
  • 6Surgery, A.S Hospital Costa del Sol, 29603 - Malaga/ES
  • 7Oncology, A.S Hospital Costa del Sol, 29603 - Malaga/ES
  • 8Medical Oncology, Hospital Costa del Sol, 29602 - Malaga/ES
  • 9Research Unit, A.S Hospital Costa del Sol, 29603 - Malaga/ES

Abstract

Background

Breast cancers (BC) detected by mammographic screening have shown to have better prognosis than symptomatic ones. The benefit of adjuvant chemotherapy (CT) in some localized BC is controversial, as it has potential side effects. The objective of this study is to analyze survival differences of adjuvant CT among screening BC.

Methods

This is a cohort study with 1.248 breast cancers included from 4 screening national programs, between 2000-2006. Follow-up was ended in 2014. Risk of death was estimated through Cox analysis. Hazard Ratio was adjusted by chemotherapy groups (with or without CT) and stage.

Results

Two hundred sixty six prevalent cases were diagnosed (41,7% with CT), 633 Incident (40,9% with CT), and 349 interval carcinomas (59,6% with CT). After a median follow-up of 102 months deaths were 22.1% for Interval, 10.4% for Incident and 7,9% for prevalent carcinomas. Prevalent and Incident carcinomas who did not receive CT had no differences in death risk with respect to those who received CT adjusting by the stage. However, comparing to Prevalent carcinomas without CT, Interval carcinomas have shown an increase risk of death more pronounced when CT is not administered (Table).

Risk of death was estimated through Cox analysis. ** Hazard Ratio adjusted by chemotherapy groups (with or without CT) and stage

Death Risk
HR aHR**
Screening BC group
Prevalent Ref
Incident 1,42 (0,87-2,34)
Interval 3,5 (2,15-5,7)
Group + CT
Prevalent without CT Ref Ref
Prevalent with CT 0,54 (0,22-1,34) 1,72 (0,66-4,47)
Incident with CT 1,34 (0,67-2,67) 2,12 (0,92-4,89)
Incident without CT 0,91 (0,45-1,82) 1,82 (0,79-4,17)
Interval with CT 2,44 (1,25-4,75) 3,14 (1,37-7,17)
Interval without CT 3,3 (1,66-6,56) 3,69 (1,56-8,74)

Conclusions

Interval carcinoma is a screen-detected tumor with a worse prognosis compared to Incident and prevalent carcinomas. Adjuvant CT did not modify survival in Prevalent and incident carcinomas. Therefore, the detection methods should be taken into account before administering adjuvant CT.

Clinical trial identification

Legal entity responsible for the study

Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC)

Funding

Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC)

Disclosure

All authors have declared no conflicts of interest.