Comparison of Adjuvant Radiation Therapy Alone Versus Radiation Therapy and Endocrine Therapy in Elderly Women With Early-Stage, Hormone Receptor-Positive Breast Cancer Treated With Breast-Conserving Surgery

Murphy, Colin T.; Li, Tianyu; Wang, Lora S.; Obeid, Elias; Bleicher, Richard J.; Eastwick, Gary; Johnson, Matthew E.; Hayes, S.B.; Weiss, Stéphanie; Anderson, Penny R.

doi:10.1016/j.clbc.2015.02.005

Cited by 21 publications

(27 citation statements)

References 22 publications

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“…Radiation therapy is used in breast cancer following the mastectomy or surgery. However, radiotherapy showed relapse of about 7–12.6% among patients with 5 years and high resistance can occur; therefore, it is preferred to use a combination of radiotherapy and hormonal treatment especially if the size of the tumor is greater than 1 cm [ 4 , 106 , 107 ].…”

Section: Treatments Of Metastatic Breast Cancermentioning

confidence: 99%

Metastatic and triple-negative breast cancer: challenges and treatment options

Al-Mahmood

Sapiezynski

Garbuzenko

et al. 2018

Drug Deliv. and Transl. Res.

411

258

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The major current conventional types of metastatic breast cancer (MBC) treatments include surgery, radiation, hormonal therapy, chemotherapy, or immunotherapy. Introducing biological drugs, targeted treatment and gene therapy can potentially reduce the mortality and improve the quality of life in patients with MBC. However, combination of several types of treatment is usually recommended. Triple negative breast cancer (TNBC) accounts for 10–20% of all cases of breast carcinoma and is characterized by the low expression of progesterone receptor (PR), estrogen receptor (ER), and human epidermal growth factor receptor 2 (HER2). Consequently, convenient treatments used for MBC that target these receptors are not effective for TNBC which therefore requires special treatment approaches. This review discusses the occurrence of MBC, the prognosis and predictive biomarkers of MBC, and focuses on the novel advanced tactics for treatment of MBC and TNBC. Nanotechnology-based combinatorial approach for the suppression of EGFR by siRNA and gifitinib is described.

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Section: Treatments Of Metastatic Breast Cancermentioning

confidence: 99%

Metastatic and triple-negative breast cancer: challenges and treatment options

Al-Mahmood

Sapiezynski

Garbuzenko

et al. 2018

Drug Deliv. and Transl. Res.

411

258

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“…7 Treatment with anti-estrogen therapy can 8 reduce the risk of local recurrence whether or not a patient undergoes radiation therapy, however, the improvement in regional control and survival are dependent on treatment adherence. 38 Nonadherence to anti-estrogen therapy has been reported as high as 51% in the literature and shown to be related to worse outcomes. [36][37][38][39] Most early discontinuation occurs within the first year of treatment.…”

Section: Discussionmentioning

confidence: 99%

“…38 Nonadherence to antiestrogen therapy has been reported as high as 51 per cent in the literature and shown to be related to worse outcomes. [36][37][38][39] Most early discontinuation occurs within the first year of treatment. 37 Older age is associated with poor adherence to hormone therapy over time.…”

Section: Discussionmentioning

confidence: 99%

“…37 Older age is associated with poor adherence to hormone therapy over time. 7,36,38,40 Frailty is associated with noninitiation of hormone therapy; however, it does not seem to be related to nonadherence. 36 Reasons cited for hormone therapy nonadherence are adverse side effects, financial constraints, and development of a second malignancy.…”

Section: Discussionmentioning

confidence: 99%

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Outcomes after Mastectomy and Lumpectomy in Octogenarians and Nonagenarians with Early-Stage Breast Cancer

Merrill¹,

Brown

Klepin

et al. 2017

The American Surgeon™

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Prospective studies have shown equal outcomes after mastectomy or breast conservation in patients with invasive breast cancer; however, many of these studies excluded elderly patients. We identified patients in their eighties and nineties with clinical stage 0 to II breast cancer undergoing mastectomy or lumpectomy with or without radiation from the prospective sentinel lymph node database at Wake Forest Baptist Health and analyzed their treatment and survival. Of 92 patients, 24 (26.1%) underwent mastectomy, 22 (23.9%) lumpectomy with radiation, and 46 (50.0%) lumpectomy alone. Significant differences were noted in tumor size (P = 0.018), nodal status (P = 0.013), and stage (P = 0.011) between the groups. Only 7.6 per cent of patients had chemotherapy, whereas 51.1 per cent took antiestrogen therapy. Recurrence occurred in 11 patients. In univariate analysis, overall survival did not differ by surgery. Age was the only factor that increased risk of death (HR = 1.19, P = 0.028). In this age group, neither tumor factors nor the type of local treatment significantly influenced overall survival. Octogenarians and nonagenarians with early-stage breast cancer undergoing breast-conserving surgery with or without radiation have equivalent survival to patients having a mastectomy.

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“…1 Data from the Early Breast Cancer Trialists’ Collaborative Group demonstrated significant benefits in terms of survival and recurrence with the use of tamoxifen, showing that among women older than 70 years, the ratio of annual events for treated patients versus control subjects was 0.49. 29 In a study of 504 women ages 65 years or older with early-stage ER+ disease undergoing lumpectomy and radiotherapy, Murphy et al 30 found that endocrine therapy nonadherence was predictive of distant metastasis and lower disease-free survival.…”

Section: Discussionmentioning

confidence: 99%

Early-Stage Breast Cancer in the Octogenarian: Tumor Characteristics, Treatment Choices, and Clinical Outcomes

et al. 2016

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Background Nodal staging with sentinel node biopsy (SLNB), post-lumpectomy radiotherapy (RT), and endocrine therapy (ET) for estrogen receptor-positive (ER+) tumors is valuable in the treatment of early-stage (stages 1 or 2) breast cancer but used less often for elderly women. Methods This retrospective study investigated women referred for surgical evaluation of biopsy-proven primary early-stage invasive breast cancer from January 2001 to December 2010. Clinicopathologic features, treatment course, and outcomes for women ages 80–89 years and 50–59 years were compared. Results The study identified 178 eligible women ages 80–89 years and 169 women ages 50–59 years. The elderly women more often had grade 1 or 2 disease (p = 0.003) and ER+ tumors (p = 0.007) and less frequently had undergone adjuvant therapies (all p ≤ 0.001). Lumpectomy was performed more commonly for the elderly (92 vs. 83 %, p = 0.02), and axillary surgery was less commonly performed (46 vs. 96 %; p < 0.001). Fewer elderly women had undergone post-lumpectomy RT (42 vs. 89 %; p < 0.001) and ET for ER+ tumors (72 vs. 95 %; p < 0.001). During the median follow-up period of 56 months for the 80- to 89-year old group and 98 months for the 50- to 59-year-old group, death from breast cancer was similar (4 vs. 5 %; p = 0.5). The two groups respectively experienced 7 versus 6 locoregional recurrences and 11 versus 13 distant recurrences. Conclusions The octogenarians had disease survivorship similar to that of the younger women despite less frequent use of adjuvant therapies, likely reflecting lower-risk disease features. Whether increased use of axillary surgery, post-lumpectomy RT, and/or ET for ER+ tumors would further improve outcomes is an important area for further study, but treatment should not be deferred solely on the basis of age.

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Comparison of Adjuvant Radiation Therapy Alone Versus Radiation Therapy and Endocrine Therapy in Elderly Women With Early-Stage, Hormone Receptor-Positive Breast Cancer Treated With Breast-Conserving Surgery

Cited by 21 publications

References 22 publications

Metastatic and triple-negative breast cancer: challenges and treatment options

Metastatic and triple-negative breast cancer: challenges and treatment options

Outcomes after Mastectomy and Lumpectomy in Octogenarians and Nonagenarians with Early-Stage Breast Cancer

Early-Stage Breast Cancer in the Octogenarian: Tumor Characteristics, Treatment Choices, and Clinical Outcomes

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