Underuse, misuse of hormone Tx in breast cancer still occurring

(HealthDay)—Adjuvant endocrine therapy (AET) can reduce the likelihood that women diagnosed with certain breast cancers will experience a recurrence of their disease, but these treatments are still too seldom utilized, or used incorrectly, according to a study published online Feb. 2 in JAMA Oncology.

The study, led by Dezheng Huo, M.D., Ph.D., associate professor of public health sciences at the University of Chicago, involved 981,729 women with breast cancer who were included in a nationwide cancer registry. Of these patients, 818,435 had hormone receptor-positive (HR+) cancer and 163,294 had HR-negative (HR−) cancer.

The team found that while underuse and misuse of AET decreased over the study period of 2004 to 2013, optimal use has not been achieved and significant variation in care persists. Among patients with HR+ cancer, receipt of AET increased from 69.8 percent in 2004 to 82.4 percent in 2013. Receipt of AET decreased among patients with HR− cancer, from 5.2 percent in 2004 to 3.4 percent in 2013. Significant variation was seen by age, race, geographic location, and receptor status. Surgery and radiotherapy were found to be the factors most significantly associated with appropriate AET receipt.

"Our findings suggest that local treatment, including surgery and radiotherapy, may play a substantial role in AET decision making," the authors write. "Facilitation of multidisciplinary team-based care may help optimize guideline-concordant treatment by ensuring patients are not lost to follow-up and are recommended for evidence-based care."