China Oncology ›› 2019, Vol. 29 ›› Issue (8): 561-567.doi: 10.19401/j.cnki.1007-3639.2019.08.001

Previous Articles     Next Articles

Current status of adjuvant therapy for early stage breast cancer in China: a cross-sectional study based on 110 hospitals

ZHANG Qi, GUO Rong, LI Lun, XIU Bingqiu, YANG Benlong, WANG Jia, JI Weiru, SHAO Zhimin, WU Jiong   

  1. Department of Breast Surgery, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
  • Online:2019-08-30 Published:2019-09-29
  • Contact: WU Jiong E-mail: wujiong1122@vip.sina.com

Abstract: Background and purpose: Adjuvant therapy is one of the important components of comprehensive treatment for breast cancer. This research aimed to investigate the current status of breast cancer treatment and master the development of postoperative adjuvant therapy for early stage breast cancer in China. Methods: A total of 110 medical institutions nationwide with more than 200 cases of breast cancer surgery yearly were selected into a questionnaire survey. The survey included basic information of the surgeons and their hospitals, information of breast cancer surgery in 2017 and decision-making on hot topics related to postoperative adjuvant therapy. Results: In this study, 80.9% of the hospitals surveyed used clinicopathological biomarkers as a prognostic evaluation tool, and the proportion of multi-gene detection tools was less than 20%. For patients with T 1a stage disease, 48.2% of hospitals used targeted therapy for human epidermal growth factor receptor 2 (HER2)-positive subtype, and 77.3% advocated chemotherapy for patients with triple-negative breast cancer (TNBC). The anthracycline followed by taxane regimen was most commonly used in chemotherapy. For patients with high risk of recurrence, 70.9% hospitals advocated dose-dense chemotherapy, but the actual implementation rates of most hospitals were less than 20%. For hormone receptor-positive patients, more than half of the hospitals recommended endocrine therapy for 10 years. The proportion of postmenopausal patients using bisphosphonate was less than 40%, and the proportion of premenopausal patients using ovarian function suppression (OFS) was also below 40%. Aromatase inhibitor (AI) was a recognized combination of OFS. Conclusion: At present, the proportion of multi-gene prognostic tools used in domestic hospitals is relatively low, and the decision-making of adjuvant therapy for early breast cancer patients is conservative. The application rates of dose-dense chemotherapy, OFS and bisphosphonate are at a low level. The clinical application of the anthracycline followed by taxane regimen and AI has formed a consensus, and prolonging the duration of endocrine therapy has also become a new trend.

Key words: Breast cancer, Adjuvant chemotherapy, Endocrine therapy, Questionnaire survey