Abstract P4-11-15: Variability in physician treatment decisions for HR+ / HER 2 negative Early Breast Cancer in young patients: a Latin-American survey

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Abstract Introduction: Breast cancer in young people (age ≤ 40), represents 5% of all breast cancer cases. Population outcomes for this group are often derived from subgroup analyses of randomized or retrospective trials. Limited data about physicians' knowledge, attitudes and practices as they relate to this diagnosis. The aim of our study was to evaluate the decision-making process in Latin-American oncologists for the treatment of young women with early breast cancer. Methods: A survey was designed with 30 items. Principal topics included: use of ovarian suppression, indication for adjuvant chemotherapy, fertility, use of genomic tests and recommendations for management of treatment-associated symptoms. Content validation was undertaken by Argentinian oncologists of SUMA (Argentinian Group for the treatment and research of breast cancer ). The study was conducted via an online questionnaire, sent by email to professional societies and to oncologists involved in the management of breast cancer patients. Descriptive analyses were included. Chi square test was performed to evaluate relationships between physician characteristics (country, gender, years of expertise, whether the physician worked in a tumor specific clinic or not) and responses. The level of statistical significance was set at p < 0.05, two-tailed. Results: A total of 329 Latin American oncologists from 17 Latin-American countries participated in the electronic survey. The responding oncologists included 74.5% who treated patients with any tumor type (ALLT), 14.6% specialized in breast and gynecological tumors (BRGY), and 10.9% focused exclusively on breast tumors (BREX). Working in a tumor-specific clinic was associated with differential utilization of several treatments or diagnostic tests, including ovarian suppression (OFS) for therapeutic purposes during neo/adjuvant chemotherapy (74.7% ALLT, 91.6% BRGY, 86.1% BREX; p=0.031), selective recommendation for OFS with endocrine therapy during the adjuvant setting (51.4% ALLT, 66.6% BRGY, 75% BREX; p < 0.001), and routine evaluations of FSH levels during treatment with OFS (70.5% ALLT, 86.8% BRGY, 86.2% BREX; p=0.038). Genetic counseling was always offered in young patients by 47.8%, 72.9% and 69.4% of physicians with ALLT, BRGY and BREX clinics, respectively (p=0.014). The use of genomic platforms for decision-making also differed: 55.6% of BREX oncologists reported always using these platforms in cases of young women compared to 38.8% of oncologists who treat all types of tumors (p <0.001). Specifically, chemotherapy was recommended to patients with recurrence score higher than 20 by 49%, 77.8% and 60.4% of oncologists with ALLT, BRGY and BREX clinics, respectively (p=0.003) The reported practices did not differ among professionals from different countries. Conclusions: According to the results of our survey the approach to managing early HR+ HER2- negative breast cancer in young women differ depending by professional focus. Full results will be presented. Further research is needed to understand the basis for these differences. However, given the heterogeneity of responses, our study highlights the need for specific guidelines for the management of breast cancer in young patients. Citation Format: Dana P. Narvaez, Federico Waisberg, Victoria Costanzo, Danilo Aguirre, Cynthia Villarreal, Matías Chacón, Sergio Rivero, Alexis Ostinelli, Fernando Namuche Ojeda, Alvaro Encinas Casanave, María Lucila González Donna, Cinthia Gauna, Juana Vazquez, María P. Molina Espinosa, Sara C. Altuna Mujica, Ronald Limón, Kayra K.Sanchez Muñoz, Claudia Martinez, Adrian Nervo, Gonzalo Gomez Abuin, Santiago Bella, Andrea Aguilar, Vanesa Lopez, Pablo Mandó, Valeria Caceres. Variability in physician treatment decisions for HR+ / HER 2 negative Early Breast Cancer in young patients: a Latin-American survey [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2024; 2024 Dec 10-13; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(12 Suppl):Abstract nr P4-11-15.

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