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©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
Oncologic efficacy of gonadotropin-releasing hormone agonist in hormone receptor-positive very young breast cancer patients treated with neoadjuvant chemotherapy
Hee Jun Choi, Jun Ho Lee, Chang Shin Jung, Jai Min Ryu, Byung Joo Chae, Se Kyung Lee, Jong Han Yu, Seok Won Kim, Seok Jin Nam, Jeong Eon Lee, Youn Joo Jung, Hyun Yul Kim
Hee Jun Choi, Jun Ho Lee, Chang Shin Jung, Department of Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon 51353, South Korea
Jai Min Ryu, Byung Joo Chae, Se Kyung Lee, Jong Han Yu, Seok Won Kim, Seok Jin Nam, Jeong Eon Lee, Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea
Youn Joo Jung, Hyun Yul Kim, Department of Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Gyeongnam 50612, South Korea
Author contributions: Choi HJ is the first author, planed and wrote this manuscript; all played a role in the data organization and modulation of this article; Kim HY planed, revised, edited and submitted this article.
Institutional review board statement: This study was approved by the Institutional Review Board of the Samsung Medical Center, Seoul, Korea (IRB file No. 2017-12-118-002). To protect personal information, patient records and information were anonymized and identities were removed prior to analysis.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Data sharing statement: Dataset available from the corresponding author at isepa102@naver.com.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Hyun Yul Kim, MD, PhD, Associate Professor, Department of Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Beomeo-ri, Mulgeum-eup, Yangsan-si, Gyeongnam 50612, South Korea. isepa102@naver.com
Received: June 23, 2023
Peer-review started: June 23, 2023
First decision: July 4, 2023
Revised: July 17, 2023
Accepted: August 25, 2023
Article in press: August 25, 2023
Published online: September 26, 2023
BACKGROUND
Breast cancer in young women has been shown to have an aggressive behavior and poor prognosis.
AIM
To evaluate the outcomes of young hormone receptor (HR)-positive patients with breast cancer treated with neoadjuvant chemotherapy (NAC), and the oncologic efficacy of gonadotropin-releasing hormone (GnRH) agonists.
METHODS
This retrospective study involved a prospectively enrolled cohort. We included patients diagnosed with invasive breast cancer who were treated with NAC followed by curative surgery at the Samsung Medical Center and Samsung Changwon Hospital between January 2006 and December 2017. Among patients with HR-positive and human epidermal grow factor 2 (HER2)-negative breast cancer, we analyzed the characteristics and oncology outcomes between the patients equal to or younger than 35 years and the patients older than 35 years.
RESULTS
Among 431 patients with NAC and HR-positive/HER2-negative breast cancer, 78 were 35 years old or younger, and 353 patients were older than 35 years. The median follow-up was 71.0 months. There was no statistically significant difference in disease free survival (DFS, P = 0.565) and overall survival (P = 0.820) between the patients equal to or younger than 35 years and the patients older than 35 years. The two groups differed in that the GnRH agonist was used more frequently in the group of patients equal to or younger than 35 years than in the other group (52.4% vs 11.2%, P < 0.001). Interestingly, for the DFS according to the GnRH agonist in the group of patients equal to or younger than 35 years, patients treated with the GnRH agonist had better DFS (P = 0.037).
CONCLUSION
Administration of GnRH agonists might improve the DFS rate of HR-positive/HER2-negative breast cancer in the equal to or younger than 35 years group of patients with NAC.
Core Tip: The treatment of ovarian suppression was effected a better oncology outcome in the group with clinical high risk, hormone receptor (+) breast cancer. However few studies have compared the efficacy of gonadotropin-releasing hormone (GnRH) agonists for 2 years in patients with neoadjuvant chemotherapy. The aim of our study was to evaluate the efficacy of GnRH agonist treatment in young breast cancer patients.
