title: Predictors of Antiestrogen Recommendation in Women With Estrogen Receptor-Positive Ductal Carcinoma In Situ.
abstract: Antiestrogen (anti-e) use in estrogen receptor-positive (ER+) ductal carcinoma in situ (DCIS) has been shown to reduce the incidence of noninvasive and invasive breast cancer. Few studies have evaluated factors associated with anti-e recommendation in ER+ DCIS.
  
  
  
  The California Cancer Registry was queried for female patients diagnosed with ER+ DCIS and treated with lumpectomy or unilateral mastectomy from 2004 to 2011. Patient demographics, comorbidities, and clinical characteristics were analyzed for association with anti-e recommendation.
  
  
  
  Of 5,527 patients identified, 76.4% patients underwent lumpectomy and 23.6% underwent unilateral mastectomy. Of the total cohort, 31.6% patients were recommended anti-e therapy, 60.4% were not, and the remaining 8.0% were recommended anti-e, but administration was not documented. Performance of lumpectomy predicted anti-e use compared with mastectomy (odds ratio [OR], 2.08; 95% CI, 1.77-2.43). Asian/Pacific Islanders were more often recommended anti-e therapy when compared with whites (OR, 1.28; 95% CI, 1.10-1.49). Patients younger than 70 years were more often recommended anti-e (age, 18-49 years: OR, 1.38; CI, 1.12-1.71; and age, 50-69 years: OR, 1.43; CI, 1.20-1.71).
  
  
  
  Despite current guidelines to consider the use of anti-e therapy, recommendation of anti-e after surgical treatment of DCIS is low, having been recommended to 40% of patients, and used by fewer than one-third. Significant predictors include lumpectomy compared with unilateral mastectomy, Asian/Pacific Islander race, younger age, and number of comorbidities. Further work is merited to understand patterns of anti-e therapy recommendation by providers in patients with DCIS.
authors: From the Departments of Oncologic Surgery, Biostatistics and Population Sciences, and Medical Oncology, City of Hope National Medical Center, Duarte, California.
authors: Rondi M
authors: RM
authors: Kauffmann
authors: From the Departments of Oncologic Surgery, Biostatistics and Population Sciences, and Medical Oncology, City of Hope National Medical Center, Duarte, California.
authors: Leanne
authors: L
authors: Goldstein
authors: From the Departments of Oncologic Surgery, Biostatistics and Population Sciences, and Medical Oncology, City of Hope National Medical Center, Duarte, California.
authors: Emily
authors: E
authors: Marcinkowski
authors: From the Departments of Oncologic Surgery, Biostatistics and Population Sciences, and Medical Oncology, City of Hope National Medical Center, Duarte, California.
authors: George
authors: G
authors: Somlo
authors: From the Departments of Oncologic Surgery, Biostatistics and Population Sciences, and Medical Oncology, City of Hope National Medical Center, Duarte, California.
authors: Yuan
authors: Y
authors: Yuan
authors: From the Departments of Oncologic Surgery, Biostatistics and Population Sciences, and Medical Oncology, City of Hope National Medical Center, Duarte, California.
authors: Philip H G
authors: PH
authors: Ituarte
authors: From the Departments of Oncologic Surgery, Biostatistics and Population Sciences, and Medical Oncology, City of Hope National Medical Center, Duarte, California.
authors: Laura
authors: L
authors: Kruper
authors: From the Departments of Oncologic Surgery, Biostatistics and Population Sciences, and Medical Oncology, City of Hope National Medical Center, Duarte, California.
authors: Leslie
authors: L
authors: Taylor
authors: From the Departments of Oncologic Surgery, Biostatistics and Population Sciences, and Medical Oncology, City of Hope National Medical Center, Duarte, California.
authors: Courtney
authors: C
authors: Vito
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D015331:Cohort Studies; D020847:Estrogen Receptor Modulators / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011960:Receptors, Estrogen / Q000378:metabolism*; D055815:Young Adult
chemical_list: D020847:Estrogen Receptor Modulators; D011960:Receptors, Estrogen