{
  "abstract": "Background/Objectives: Patients with high-risk early-stage oestrogen receptor-positive/human epidermal growth factor receptor 2-negative early breast cancer (ER+/HER2– eBC) remain at high risk of recurrence despite standard endocrine therapy. Given the limited real-world data in Italy, this analysis evaluated treatments, economic burden and clinical outcomes in routine practice. Methods: Administrative healthcare databases linked with pathology data were used to identify patients with ER+/HER2– eBC undergoing surgery. The overall population (Cohort #1) comprised patients identified between January 2010 and June 2024. A subset meeting high-risk criteria constituted Cohort #2 (Grade 3 tumours AND clinical stage T1c–T2/N1–N2 or T3–T4/N0–N2; when TNM components were unavailable, clinical stage II–III patients were included). Healthcare resource utilisation and direct costs were assessed during neoadjuvant, adjuvant, and follow-up phases. Recurrence rate, real-world event-free survival and overall survival were evaluated during the 4 years post-surgery using Kaplan–Meier curves. Results: Among 17,731 patients identified as ER+/HER2– eBC (Cohort #1), 366 were classified as high-risk (Cohort #2). The descriptive analysis documented substantial healthcare resource utilisation and direct costs in the high-risk subgroup during both neoadjuvant and adjuvant phases, together with a considerable recurrence burden and reduced survival probabilities. Conclusions: This descriptive real-world analysis provides estimates of the clinical and economic burden of ER+/HER2– eBC in the real Italian practice, with a focus on the high-risk subgroup. Post-surgery cost estimates reflect healthcare expenditure during recurrence-free follow-up and do not capture the costs of recurrent or metastatic disease. These findings highlight the healthcare resources required for the management of high-risk eBC and the need for continued efforts to improve clinical outcomes.",
  "abstract_shown": true,
  "affiliations": [
    "Humanitas Research Hospital, 20072 Milan, Italy",
    "Division of Early Drug Development, European Institute of Oncology, IRCCS, 20141 Milan, Italy",
    "CliCon S.r.l. Società Benefit, Health, Economics & Outcomes Research, 40137 Bologna, Italy",
    "Merck & Co., Inc., Rahway, NJ 00765, USA"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Carmen Criscitiello"
    },
    {
      "affs": [
        2
      ],
      "name": "Valentina Perrone",
      "orcid": "0000-0001-5018-490X"
    },
    {
      "affs": [
        2
      ],
      "name": "Luca Degli Esposti",
      "orcid": "0000-0002-7020-6659"
    },
    {
      "affs": [
        2
      ],
      "name": "Stefania Mazzoni"
    },
    {
      "affs": [
        3
      ],
      "name": "Kaushal Desai"
    },
    {
      "affs": [
        3
      ],
      "name": "Kim M. Hirshfield"
    },
    {
      "affs": [
        3
      ],
      "name": "Jagadeswara Rao Earla",
      "orcid": "0000-0002-6688-5273"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/5qwxb6f8rs2jq.bib",
  "cited_by": 0,
  "doi": "10.3390/cancers18213467",
  "fulltext_url": null,
  "id": "5qwxb6f8rs2jq",
  "issns": [
    "2072-6694"
  ],
  "landing_url": "https://www.mdpi.com/2072-6694/18/21/3467",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "1306|Breast Cancer Treatment Studies"
    ]
  ],
  "openalex": "W7223897344",
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-27",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/5qwxb6f8rs2jq.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:58Z",
      "native_id": "10.3390/cancers18213467",
      "source": "crossref",
      "url": "https://www.mdpi.com/2072-6694/18/21/3467"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:1306|Breast Cancer Treatment Studies",
      "subfield": "oncology"
    }
  ],
  "title": "Chemotherapy Use, Healthcare Resource Utilisation, and Direct Costs in High-Risk Early-Stage ER+/HER2– Breast Cancer in Italy: A Real-World Study Linking Administrative and Pathology Data",
  "title_text": "Chemotherapy Use, Healthcare Resource Utilisation, and Direct Costs in High-Risk Early-Stage ER+/HER2– Breast Cancer in Italy: A Real-World Study Linking Administrative and Pathology Data",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:58Z",
  "url": "https://research.draconitic.com/paper/5qwxb6f8rs2jq",
  "venue": "Cancers",
  "versions": []
}