Is primary endocrine therapy effective in treating the elderly, unfit patient with breast cancer?

Healthcare professionals' preferences for surgery or primary endocrine therapy to treat older women with operable breast cancer

“…With dementia predominantly affecting the elderly, this represents a significant problem in this population. Studies show that older patients with dementia are less likely to receive standard cancer therapies [12] and that this is often stated as a reason for selecting PET over surgery [6,39]. However, there are currently no guidelines for the treatment of operable breast cancer in this complex group of patients which may reflect the lack of consensus amongst HCPs surveyed here.…”

Primary endocrine therapy as a treatment for older women with operable breast cancer – A comparison of randomised controlled trial and cohort study findings

“…Interestingly, one study that reported that 32% of included patients were unfit for surgery yet had a 93% 5-year survival rate which highlights how difficult predicting probable life expectancy can be [19]. Osborn and colleagues [15] in their study were the only authors to use a formal assessment of comorbidity. They used the Charlson Index and reported that only 34% of their patients had a greater than 2% chance of surviving 10 years, with only 6 patients having a greater than 50% chance of surviving 10 years.…”

“…Several recent studies have found that up to 40% of patients over 70 years old are treated with PET in the UK [11,12]. Additionally, there have been several new studies published within the last two years looking at cohorts of women treated using PET [13][14][15][16][17][18][19][20][21][22]. The methodology of these cohort studies vary greatly, particularly in terms of the treatment used, the fitness of included patients and whether ER testing was performed, again limiting the overall applicability to modern clinical practice.…”

What influences healthcare professionals' treatment preferences for older women with operable breast cancer? An application of the discrete choice experiment

“…Furthermore a recent study demonstrated a lack of consensus among HCPs regarding the optimal way to treat this group [12]. Older patients with dementia are less likely to receive standard cancer therapies [28] and this is often stated as an explanation for selecting PET over surgery [5,29].…”