title: Neoadjuvant endocrine treatment in breast cancer: analysis of daily practice in large cancer center to facilitate decision making.
abstract: BACKGROUND
  To examine outcomes of neoadjuvant endocrine therapy in daily practice to inform decision making.
  
  
  METHODS
  We retrospectively selected 204 patients who received neoadjuvant endocrine therapy with T2 (≥30 mm) or T3 tumors, examining subsequent breast-sparing surgery and long-term outcomes.
  
  
  RESULTS
  Neoadjuvant endocrine therapy was administered for 7.3 months (median) and breast-sparing surgery was achievable in 53% of patients. Smaller initial tumor size and modified version of the Scarff-Bloom and Richardson grades 1 to 2 were associated with breast-sparing surgery. Disease progression during treatment was 6.9%; actuarial risk of local relapse was 3% at 5 years and 15% at 10 years. Five- and 10-year metastasis relapse-free survival was 78% and 63%, respectively. Grade 3, negative progesterone receptors, and absence or slow response to neoadjuvant therapy were associated prognostic factors.
  
  
  CONCLUSIONS
  These daily practice data provide important information about feasibility, efficacy, and long-term results of neoadjuvant endocrine therapy and can be used to inform patients for decision making between mastectomy and endocrine induction therapy.
authors.affiliation: Department of Medical Oncology, Institut Bergonié, 229 cours de l'Argonne, F-33000 Bordeaux, France. Electronic address: m.debled@bordeaux.unicancer.fr.
authors.forename: Marc
authors.initials: M
authors.lastname: Debled
authors.affiliation: Department of Surgery, Institut Bergonié, 229 cours de l'Argonne, F-33000 Bordeaux, France.
authors.forename: Gaël
authors.initials: G
authors.lastname: Auxepaules
authors.affiliation: Department of Surgery, Institut Bergonié, 229 cours de l'Argonne, F-33000 Bordeaux, France.
authors.forename: Christine Tunon
authors.initials: CT
authors.lastname: de Lara
authors.affiliation: Department of Medical Oncology, Institut Bergonié, 229 cours de l'Argonne, F-33000 Bordeaux, France.
authors.forename: Delphine
authors.initials: D
authors.lastname: Garbay
authors.affiliation: Clinical and Epidemiological Research Unit, Institut Bergonié, 229 cours de l'Argonne, F-33000 Bordeaux, France.
authors.forename: Véronique
authors.initials: V
authors.lastname: Brouste
authors.affiliation: Department of Surgery, Institut Bergonié, 229 cours de l'Argonne, F-33000 Bordeaux, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Bussières
authors.affiliation: Department of Medical Oncology, Institut Bergonié, 229 cours de l'Argonne, F-33000 Bordeaux, France.
authors.forename: Louis
authors.initials: L
authors.lastname: Mauriac
authors.affiliation: Department of Pathology, Institut Bergonié, 229 cours de l'Argonne, F-33000 Bordeaux, France.
authors.forename: Gaëtan
authors.initials: G
authors.lastname: MacGrogan
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D047072:Aromatase Inhibitors / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D003657:Decision Making; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental / Q000706:statistics & numerical data; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D010358:Patient Participation; D012189:Retrospective Studies; D016019:Survival Analysis; D013629:Tamoxifen / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D018931:Antineoplastic Agents, Hormonal; D047072:Aromatase Inhibitors; D013629:Tamoxifen
keywords: Breast neoplasms; Breast-conserving surgery; Neoadjuvant endocrine therapy; Shared decision making