Hormone replacement therapy (HRT) in women with previously treated primary breast cancer. Update XIV

Abstract

20693 Background: To assess the incidence of contralateral or recurrent breast cancer among women prospectively treated with HRT after initial breast cancer diagnosis. Methods: A community-based, prospective, single-arm, pilot study of HRT among 248 women with previously treated primary breast cancer. Results: Median duration of HRT is 90+ months (range 12+ -185+). Median interval from last menses to initiation of HRT is 120 months (range 2–612). Median interval from initial surgery to initiation of HRT is 50 months (range 2–361 months). One hundred and twenty two patients have stopped HRT (49%), 60 because of anxiety about taking HRT (24%), 50 because of breast cancer development (20%), 5 because of the development of non-breast cancers, 2 died of nonmalignant disease, 3 because of HRT-associated symptoms, and 2 because of hypercoagulability. CHRT, as opposed to ERT, was administered to 50% of all patients and 58% of the 50 who subsequently developed breast cancer on study. Actuarial DFS to 25 years for T1N0 patients was 67% versus 35% (DSS=86%) for comparable T1N0 patients who did not receive HRT. Conclusions: No evidence to date of increased development, recurrence or of breast cancer-related death associated with post diagnosis HRT. Actuarial disease-free survival (DFS), disease-specific survival (DSS), and median duration of HRT Stage Pt # DFS DSS HRT mos T0N0 72 78%* 100% 95+ T1N0 117 66%** 90% 96+ T2N0 19 75%*** 92% 76+ T1N1 28 58%**** 86% 72+ T2–3N1 12 64%***** 69% 70 All Patients 248 61% 88% 90+ * T0N0: 2 LCIS recurred locally after lumpectomy alone; 3 DCIS recurred locally after lumpectomy/RT; 5 contralateral tumors (3 DCIS, 2 T1N0); 1 distant recurrence - liver. (alive 4.5 years later); ** T1N0: 9 local recurrences after lumpectomy/RT; 7 contralateral tumors; 8 distant recurrences - 3 lung, 2 liver, 3 bone - 4 died; *** T2N0: 2 local recurrences after lumpectomy/RT; 2 distant recurrences - lung - 1 died; **** T1N1: 3 local recurrence after lumpectomy/RT; 2 contralateral tumors; 2 distant recurrences - 1 bone, 1 supraclav node - 2 died; ***** T2–3N1: 1 contralateral tumor: 3 distant recurrences - 1 cerv node-2 bone mets - 3 died. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Expert Testimony Other Remuneration Wyeth