Treatment Strategies in Octogenarians with Early-Stage, High-Risk Breast Cancer
| Autor: | Dayna T. Neo, Abram Recht, Julie J. Gonzalez, Michele R. Hacker, Ranjna Sharma, Anita Mamtani, Robb S. Friedman |
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| Rok vydání: | 2017 |
| Předmět: |
Oncology
medicine.medical_specialty Lymphovascular invasion Receptor ErbB-2 medicine.medical_treatment Antineoplastic Agents Breast Neoplasms Triple Negative Breast Neoplasms 03 medical and health sciences 0302 clinical medicine Breast cancer Trastuzumab Surgical oncology Risk Factors Internal medicine medicine Humans Neoplasm Invasiveness 030212 general & internal medicine Stage (cooking) Mastectomy Neoplasm Staging Retrospective Studies Aged 80 and over Chemotherapy Radiotherapy business.industry medicine.disease Tumor Burden Radiation therapy Receptors Estrogen 030220 oncology & carcinogenesis Lymphatic Metastasis Axilla Lymph Node Excision Surgery Female Neoplasm Grading Neoplasm Recurrence Local business medicine.drug |
| Zdroj: | Annals of surgical oncology. 25(6) |
| ISSN: | 1534-4681 |
| Popis: | Octogenarians with early-stage breast cancer often have low-risk tumor biology. However, optimal treatment strategies for those with high-risk biology remain unclear. We reviewed the records of women ages 80–89 years with biopsy-proven, Stage I–II invasive breast cancer who were referred for surgical evaluation from January 2001 through December 2010. High-risk was defined as human epidermal growth factor receptor-positive (HER2+), triple-negative (TN), or histologic grade 3 disease. Among 178 patients, 40 (22%) were high-risk: 12 were grade 1–2 (10 HER2 + , 2 TN); 28 were grade 3 (7 HER2+, 6 TN, 15 estrogen receptor-positive (ER+)/HER2−). The high-risk group had larger tumors and more often had ductal histology and lymphovascular invasion than the low-risk group and was more likely to undergo mastectomy (18 vs. 5%, p = 0.02), radiotherapy (55 vs. 36%, p = 0.03), and chemotherapy (10 vs. 0%, p = 0.002). Endocrine therapy use was similar among ER+ patients in both groups. The four patients in the high-risk group given chemotherapy were HER2+ and received trastuzumab-based regimens, without any reported toxicities. At median follow-up of 67 months, 10% of the high-risk group had a recurrence (3 distant-only, 1 simultaneous locoregional and distant in a patient treated with mastectomy without radiotherapy). Tailored locoregional and systemic therapy resulted in low incidence of failure in these octogenarians with high-risk cancers with low morbidity. Modern adjuvant therapies should be considered for elderly women with high-risk cancers in the absence of significant comorbidities. |
| Databáze: | OpenAIRE |
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