Oncologists Significantly Underestimate Benefits of Estrogen Therapy

According to a poster presented at the 2017 San Antonio Breast Cancer Symposium, surveyed oncologists significantly underestimate the benefits of various estrogen blockade therapies.

“Recent publication of [clinical trial data] provides additional options for premenopausal women with hormone receptor (HR)-positive breast cancer in improving estrogen blockade tamoxifen plus ovarian function suppression and aromatase inhibitors plus ovarian function suppression,” Reema Patel, MD, of the University of Kentucky, and colleagues wrote. “Analysis of these trials conclude that, for a premenopausal woman with HR-positive breast cancer with high risk features for recurrence have an absolute benefit… However, therapeutic option decision-making is dependent on the oncologists’ perception of the benefit and risk for adjuvant anti-estrogen therapy.”

The researchers designed a survey and administered that survey to 510 oncologists in the United States. The researchers asked oncologists to estimate 5-year breast cancer free interval using a 0 to 100 scale. They presented responders with five different scenarios, including lumpectomy plus radiation, lumpectomy plus radiation plus chemotherapy, lumpectomy plus radiation plus chemotherapy with 5 years of tamoxifen and ovarian function suppression, and lumpectomy plus radiation plus chemotherapy with aromatase inhibitors plus ovarian function suppression.

Dr Patel and colleagues concluded that there was no difference in the perception of added benefit when anti-estrogen therapy options were included in the treatment scenarios. 

“Regardless of their gender, practice setting, clinical experience, or volume of breast cancer patients, oncologists significantly underestimate the absolute benefit for various estrogen blockade therapies when compared to the estimated benefit of data from… clinical trial data,” they concluded. “We highlight an area for improvement in quality of care that offers an immediate impact on positive outcomes for large numbers of premenopausal women with breast cancer.”

—David Costill