Endocrine Therapy Initiation among Older Women with Ductal Carcinoma In Situ. (13th September 2017)

• Record Type: Journal Article
• Authors: Anderson, Chelsea; Winn, Aaron N.; Dusetzina, Stacie B.; Nichols, Hazel B.
• Other Names: Liotta Lance A. Academic Editor.
• Is Part Of: Journal of cancer epidemiology. Volume 2017(2017)
• Publication Date: 2017-09-13
• Subjects: Cancer -- Epidemiology -- Periodicals; 616.994005
• DOI: 10.1155/2017/6091709
• Languages: English
• ISSNs: 1687-8558

Abstract

Abstract : Background . Although treatment of ductal carcinoma in situ (DCIS) is controversial, national guidelines recommend considering endocrine therapy for women with estrogen receptor- (ER-) positive DCIS or those undergoing breast conserving surgery (BCS) without radiation. We evaluated uptake and predictors of endocrine therapy use among older women with DCIS. Methods . In the SEER-Medicare database, we identified women aged 65+ years diagnosed with DCIS during 2007–2011. We evaluated demographic, tumor, and treatment characteristics associated with endocrine therapy initiation. Results . Among 2, 945 women with DCIS, 41% initiated endocrine therapy (66% tamoxifen, 34% aromatase inhibitors). Initiation was more common among women with ER-positive than ER-negative DCIS (48% versus 16%; HR = 3.75, 95% CI: 2.91–4.83); 28% of women with unknown ER status initiated endocrine therapy. Initiation was less common after BCS alone compared to BCS with radiation (32% versus 50%; HR = 0.69, 95% CI: 0.59–0.80). Conclusions . Less than half of older women with DCIS initiate endocrine therapy to prevent second breast cancers. Our findings suggest use was more common, but not exclusive, among women with ER-positive DCIS, but not among women who underwent BCS alone. Endocrine therapy should be targeted toward patients most likely to benefit from its use.