Faculty Opinions recommendation of Surgery versus primary endocrine therapy for operable primary breast cancer in elderly women (70 years plus).

2006 ◽  
Author(s):  
Riccardo A Audisio
Keyword(s):  
Breast Cancer ◽  
Endocrine Therapy ◽  
Primary Breast Cancer ◽  
Elderly Women ◽  
Primary Endocrine Therapy

Surgery versus primary endocrine therapy for elderly women with estrogen receptor-positive early operable primary breast cancer: Survival analysis and correlation with oestrogen receptor positivity

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 612-612
Author(s):  
B. M. Syed ◽  
S. J. Johnston ◽  
D. W. M. Wong ◽  
D. A. L. Morgan ◽  
I. O. Ellis ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Endocrine Therapy ◽  
Primary Breast Cancer ◽  
Oestrogen Receptor ◽  
Elderly Women ◽  
Breast Cancer Specific Survival ◽  
Cancer Specific Survival ◽  
Er Positive ◽  
Primary Endocrine Therapy

612 Background: A recent Cochrane review of seven randomised trials involving 1,446 elderly women (unselected for oestrogen receptor (ER) status) has shown no significant difference in overall survival between surgery (with or without adjuvant tamoxifen) and primary endocrine therapy using tamoxifen. We now report results of a large series from a single centre with a dedicated elderly breast cancer service, with long term follow-up. Methods: During a period of > 20 years, 1,031 elderly (> 70 years) women with ER positive (H-score >50) early operable primary breast cancer received either surgery (with or without adjuvant endocrine therapy) (N = 436) or primary endocrine therapy (N = 595) (>80% using tamoxifen) as initial treatment, with complete follow-up information till deaths. The initial treatment was decided based on fitness for surgery and patient choice. Analysis was carried out on breast cancer specific survival and degree of ER positivity. Results: After a median follow up of 49 months (range 0 - 261 months), patients between 70 - 80 years, treated by surgery, had better 5-year breast cancer specific survival compared to their counterparts treated by primary endocrine therapy (95% versus 85%; p < 0.001). For patients > 80 years, there was however no statistical difference between the two groups (90% versus 90%; p = 0.813). The median survival has not reached yet in all groups. Patients in the latter group (> 80 years) were found to have a higher chance of having strongly ER positive tumours (57% versus 50% in patients between 70 - 80 years with H-score >200; p- < 0.02). Conclusions: In a selected group of elderly women (> 80 years) who tend to have strongly ER positive tumours, surgery and primary endocrine therapy did not appear to produce any difference in breast cancer specific survival. This subject is currently being investigated in a national randomised trial in the UK. No significant financial relationships to disclose.

Primary endocrine therapy for early operable primary breast cancer in elderly women: A large series from a single institution

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 630-630
Author(s):  
W. Al-Khyatt ◽  
B. M. Syed ◽  
D. A. Morgan ◽  
K. L. Cheung
Keyword(s):  
Breast Cancer ◽  
Endocrine Therapy ◽  
Primary Breast Cancer ◽  
Elderly Women ◽  
Randomised Trial ◽  
Cochrane Review ◽  
Complete Response ◽  
Patient Choice ◽  
Significant Difference ◽  
Primary Endocrine Therapy

630 Background: A recent Cochrane review of seven randomised trials involving 1,446 elderly women (unselected for oestrogen receptor (ER) status) has shown no significant difference in overall survival between surgery (with or without adjuvant tamoxifen) and primary endocrine therapy using tamoxifen. We report our experience of using primary endocrine therapy in a single centre with a dedicated elderly breast cancer service. Methods: Over a 20-year period, 825 elderly (>70 years) women with early operable primary breast cancer were treated with primary endocrine therapy (>80% using tamoxifen as first-line agent), due to patient choice or being unfit for surgery. All patients had disease assessable for response according to UICC criteria, and had treatment for ≥6 months unless the disease progressed prior. Results: Median age was 80 (range: 70–99) years. When the disease progressed, some patients received further lines of therapy and the overall results are summarised (Table). Conclusions: Compared to the general use of endocrine therapy reported in advanced breast cancer (where CB rate is around 70%), primary endocrine therapy in this context appears to produce superior results. They support its use as an excellent alternative in elderly women who refuse or are unfit for surgery. Its precise role compared to surgery is the focus of a national randomised trial in the UK. CR: complete response; PR: partial response; SD: stable disease; CB: clinical benefit = CR + PR + SD; PD: progressive disease; DoCB: duration of CB; TTP: time to progression (all in months). [Table: see text] No significant financial relationships to disclose.

scholarly journals Elderly women with breast cancer often die due to other causes regardless of primary endocrine therapy or primary surgical therapy

The Breast ◽  
2011 ◽  
Vol 20 (4) ◽  
pp. 365-369 ◽  
Author(s):  
M.J. Traa ◽  
C.M.E.M. Meijs ◽  
M.A.C. de Jongh ◽  
E.C.H.M. van der Borst ◽  
J.A. Roukema
Keyword(s):  
Breast Cancer ◽  
Endocrine Therapy ◽  
Surgical Therapy ◽  
Elderly Women ◽  
Primary Endocrine Therapy
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