Chemoprevention Uptake among Women with Atypical Hyperplasia and Lobular and Ductal Carcinoma In Situ
Chemoprevention Uptake among Women with Atypical Hyperplasia and Lobular and Ductal Carcinoma In Situ
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DOI：
10.1158/1940-6207.capr-17-0100
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发表时间：
2017-08-01
影响因子：
3.3
通讯作者：
Crew, Katherine D.
中科院分区：
文献类型：
--
作者：
Trivedi, Meghna S.;Coe, Austin M.;Crew, Katherine D.
患有不典型增生和小叶或导管原位癌（LCIS/DCIS）的女性患浸润性乳腺癌的风险增加。选择性雌激素受体调节剂或芳香化酶抑制剂的化学预防可以降低乳腺癌的风险;然而，在这些人群中，估计摄取率低于15%。我们试图确定哪些因素与非典型增生、LCIS和DCIS女性人群的化学预防摄取相关。确定了2007年至2015年期间诊断为非典型增生/LCIS/DCIS且无浸润性乳腺癌病史的女性（N = 1，719）。一个子集的妇女（n = 73）完成了问卷调查乳腺癌和化学预防知识，风险认知和行为意图。产生描述性统计量，并使用单变量和多变量对数二项回归来估计社会人口统计学和临床因素与化学预防摄取之间的关联。在我们的样本中，29.3%患有不典型增生，23.3%患有LCIS，47.4%患有DCIS; 29.4%使用化学预防。与非典型增生女性相比，LCIS [RR，1.43; 95%置信区间（CI），1.16-1.76]和DCIS（RR，1.54; 95% CI，1.28-1.86）与化疗预防摄取显著相关，内科肿瘤转诊也是如此（RR，5.79; 95% CI，4.80-6.98）。年轻女性不太可能采取化学预防措施（RR，0.61; 95% CI，0.42-0.87），与非西班牙裔白色女性相比，西班牙裔女性的吸收有增加的趋势。调查数据显示，人们对学习化学预防有浓厚的兴趣，但对个人乳腺癌风险和化学预防的副作用存在误解。改善有关乳腺癌风险和化学预防的沟通可能使临床医生能够促进有关预防性治疗的知情决策。(C)2017年AACR。
Women with atypical hyperplasia and lobular or ductal carcinoma in situ (LCIS/DCIS) are at increased risk of developing invasive breast cancer. Chemoprevention with selective estrogen receptor modulators or aromatase inhibitors can reduce breast cancer risk; however, uptake is estimated to be less than 15% in these populations. We sought to determine which factors are associated with chemoprevention uptake in a population of women with atypical hyperplasia, LCIS, and DCIS. Women diagnosed with atypical hyperplasia/LCIS/DCIS between 2007 and 2015 without a history of invasive breast cancer were identified (N = 1,719). A subset of women (n = 73) completed questionnaires on breast cancer and chemoprevention knowledge, risk perception, and behavioral intentions. Descriptive statistics were generated and univariate and multivariable log-binomial regression were used to estimate the association between sociodemographic and clinical factors and chemoprevention uptake. In our sample, 29.3% had atypical hyperplasia, 23.3% had LCIS, and 47.4% had DCIS; 29.4% used chemoprevention. Compared with women with atypical hyperplasia, LCIS [RR, 1.43; 95% confidence interval (CI), 1.16-1.76] and DCIS (RR, 1.54; 95% CI, 1.28-1.86) were significantly associated with chemoprevention uptake, as was medical oncology referral (RR, 5.79; 95% CI, 4.80-6.98). Younger women were less likely to take chemoprevention (RR, 0.61; 95% CI, 0.42-0.87), and there was a trend toward increased uptake in Hispanic compared with non-Hispanic white women. The survey data revealed a strong interest in learning about chemoprevention, but there were misperceptions in personal breast cancer risk and side effects of chemoprevention. Improving communication about breast cancer risk and chemoprevention may allow clinicians to facilitate informed decision-making about preventative therapy. (C) 2017 AACR.