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Annals of Oncology Advance Access originally published online on August 30, 2007
Annals of Oncology 2007 18(12):1976-1980; doi:10.1093/annonc/mdm365
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© 2007 European Society for Medical Oncology

breast cancer

Adjuvant treatment of early breast cancer: do the St Gallen recommendations influence clinical practice? Results from the NORA study

M. E. Cazzaniga1,*, G. Mustacchi2, P. Pronzato3, A. De Matteis4, F. Di Costanzo5, I. Floriani On behalf of the NORA Study Group6

1 Medical Oncology, Treviglio Hospital, Treviglio
2 Medical Oncology Department, University of Trieste, Trieste
3 Medical Oncology, IST, Genova
4 Medical Oncology C, Istituto Pascale, Napoli
5 Medical Oncology, Ospedale Careggi, Firenze
6 Oncology Department, Istituto di Ricerche Farmacologiche Mario Negri, Milano, Italy

* Correspondence to: Marina E. Cazzaniga, Medical Oncology, Ospedale di Treviglio, P. le Ospedale 1, 24047 Treviglio (BG), Italy. Tel: +39-0363424303; Fax: +39-0363424380; E-mail: oncologia{at}tin.it

Background: The NORA study is a prospective longitudinal cohort study aiming at investigating treatment in patients with early breast cancer. Here, we present the impact of the St Gallen recommendations on clinical practice.

Patients and methods: We compared adjuvant strategies in patients enrolled in 2000–2002 to those in 2003–2004 to verify the impact of the 2003 St Gallen recommendations.

Results: The use of aromatase inhibitors (AIs) doubled: 65/629 patients (10.3%) vs 100/458 patients (21.8) (P < 0.0001). Following chemotherapy, AIs were administered in 8.5% of the retrospective cohort and in 15.1% of the prospective one (P < 0.0001). The use of taxanes plus hormones dropped (P = 0.0026), but not when used as single agents. A marked increase was observed in the use of anthracycline-based chemotherapy (46.3% vs 65.2%), mainly three-drug regimens (33.3% vs 46.6%).

Conclusion: Our results suggest that the St Gallen recommendations have had a major impact on clinical practice.

Key words: adjuvant therapy, breast cancer, St Gallen recommendations

Received for publication April 22, 2007. Revision received June 10, 2007. Accepted for publication June 25, 2007.


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