Scholarlink

Background <p>The COVID-19 pandemic restricted operating room availability, prompting the Pandemic Breast Cancer Consortium to issue guidelines on deferring non-urgent surgical procedures. This led to an increased use of neoadjuvant endocrine therapy (NET) for estrogen-receptor positive (ER+) breast cancers. Irrespective of the pandemic, the ACOSOG Z1031 trial demonstrated that NET was effective at downstaging 51% of patients initially ineligible for breast conserving surgery (BCS). Despite this, NET utilization remains low. This study investigates NET use and related outcomes before, during, and after the pandemic.</p> Methods <p>Patients aged ≥&#xa0;18 with clinical T1–T4c, N0-3, ER+/HER2− breast cancers were selected from the National Cancer Database and stratified into two groups: NET versus surgery first. The study analyzed trends from 2019 (pre-pandemic) to 2021 (tail-end-pandemic). Logistic regression identified factors associated with NET utilization.</p> Results <p>Results showed that 10,935 (3.9%) patients received NET and 272,546 (96.1%) underwent surgery first. NET use peaked in 2020 at 6.4% (vs. 2019 2.3% and 2021 3.2%, <i>P</i>&#xa0;=&#xa0;0.001). Median time from diagnosis to treatment was significantly shorter in the NET group (1.02 vs. 1.35 months, <i>P</i>&#xa0;=&#xa0;0.001). Patients with clinical T3-4 disease who received NET versus surgery first had similar rates of BCS and were less likely to receive chemotherapy.</p> Conclusion <p>The use of NET nearly tripled during the COVID-19 pandemic and was associated with decreased time to treatment and less use of adjuvant chemotherapy. NET could be considered for patients requiring a delay to surgery or for those with higher T-category who desire BCS or are unable to tolerate chemotherapy.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Neoadjuvant Endocrine Therapy Use in Estrogen Receptor Positive Breast Cancer: Insights from Practice Shifts During the COVID-19 Pandemic

  • 期刊论文

  • 发表日期：

    2025年9月20日

查看全文
  • Sasha R. Douglas,
  • Samantha M. Thomas,
  • Astrid Botty van den Bruele,
  • Ton Wang,
  • Kendra M. Parrish,
  • Laura H. Rosenberger,
  • Jennifer K. Plichta,
  • Maggie L. DiNome,
  • Akiko Chiba

摘要

Background

The COVID-19 pandemic restricted operating room availability, prompting the Pandemic Breast Cancer Consortium to issue guidelines on deferring non-urgent surgical procedures. This led to an increased use of neoadjuvant endocrine therapy (NET) for estrogen-receptor positive (ER+) breast cancers. Irrespective of the pandemic, the ACOSOG Z1031 trial demonstrated that NET was effective at downstaging 51% of patients initially ineligible for breast conserving surgery (BCS). Despite this, NET utilization remains low. This study investigates NET use and related outcomes before, during, and after the pandemic.

Methods

Patients aged ≥ 18 with clinical T1–T4c, N0-3, ER+/HER2− breast cancers were selected from the National Cancer Database and stratified into two groups: NET versus surgery first. The study analyzed trends from 2019 (pre-pandemic) to 2021 (tail-end-pandemic). Logistic regression identified factors associated with NET utilization.

Results

Results showed that 10,935 (3.9%) patients received NET and 272,546 (96.1%) underwent surgery first. NET use peaked in 2020 at 6.4% (vs. 2019 2.3% and 2021 3.2%, P = 0.001). Median time from diagnosis to treatment was significantly shorter in the NET group (1.02 vs. 1.35 months, P = 0.001). Patients with clinical T3-4 disease who received NET versus surgery first had similar rates of BCS and were less likely to receive chemotherapy.

Conclusion

The use of NET nearly tripled during the COVID-19 pandemic and was associated with decreased time to treatment and less use of adjuvant chemotherapy. NET could be considered for patients requiring a delay to surgery or for those with higher T-category who desire BCS or are unable to tolerate chemotherapy.