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Utilization of Adjuvant Chemotherapy in Patients with Non-Metastatic Breast Cancer after Surgery
J. Kor. Soc. Health-syst. Pharm. 2021;38:171-184
Published online May 31, 2021;  https://doi.org/10.32429/jkshp.2021.38.2.002
© 2021 Korean Society of Health-System Pharmacists

Minhee Kua,b and Nam Kyung Jea,†

College of Pharmacy, Pusan National University, 2 Busandaehak-ro 63beon-gil, Geumjeong-gu, Busan, 46241, Republic of Koreaa Department of Pharmacy, Dongnam Institute of Radiological & Medical Sciences, 40 Jwadong-gil, Jangan-eup, Gijang-gun, 46033, Republic of Koreab
Correspondence to: 제남경 Tel:051-510-280 E-mail:jenk@pusan.ac.kr
Received January 8, 2021; Revised February 15, 2021; Accepted March 11, 2021.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background : In July 2017, breast cancer surgery codes have been revised to more accurately describe a procedure of breast cancer surgery. This study aimed to investigate the current practice patterns of breast cancer surgery and the subsequent adjuvant chemotherapy after the revision of breast cancer surgery codes.
Methods : We analyzed the 2018 inpatient datasets provided by the Health Insurance Review and Assessment Service (HIRA-NIS-2018-0047). Female patients with non-metastatic breast cancer who underwent breast cancer surgery and adjuvant chemotherapy were selected. Multinomial logistic regression analysis was performed to explore the relationships among variables regarding the selection of adjuvant chemotherapy relative to the doxorubicin and cyclophosphamide (AC) regimen.
Results : Breast-conserving surgery was performed more frequently than mastectomy (70.2% vs. 29.8%) in 2018. For study subjects who underwent axillary lymph node dissection, the odds ratio for selecting sequential anthracycline-cyclophosphamide and taxane (AC-T) as adjuvant chemotherapy over AC was 23.27 (95% confidence interval [CI]=8.61-62.91). For patients aged 65 years or older, the odds ratio for selecting cyclophosphamide, methotrexate, and 5-Fluorouracil (CMF) as adjuvant chemotherapy over AC was 12.16 (95% CI=3.22-46.00).
Conclusion : Factors influencing the choice of adjuvant chemotherapy were associated with age and presence of positive lymph nodes.
Keywords : Breast cancer, Adjuvant chemotherapy, Mastectomy, Breast-conserving surgery