Optimal adjuvant therapy in older (≥70 years of age) women with low-risk early-stage breast cancer

Abstract

Older women are under-represented in breast cancer (BC) clinical trials, and treatment guidelines are primarily based on BC studies in younger women. Studies uniformly report an increased incidence of local relapse with omission of breast radiation therapy. Review of the available literature suggests very low rates of distant relapse in women ≥70 years of age. The incremental benefit of endocrine therapy in decreasing rate of distant relapse and improving disease-free survival in older patients with low-risk BC remains unclear. Integration of molecular genomic assays in diagnosis and treatment of estrogen receptor positive BC presents an opportunity for optimizing risk-tailored adjuvant therapies in ways that may permit treatment de-escalation among older women with early-stage BC. The prevailing knowledge gap and lack of risk-specific adjuvant therapy guidelines suggests a compelling need for prospective trials to inform selection of optimal adjuvant therapy, including omission of adjuvant endocrine therapy in older women with low risk BC.

2023 Year in review: Early breast cancer

“…In a predominantly ER-negative population (78%), no statistically significant differences were observed in invasive breast cancer recurrence-free interval (HR = 0.88, 95%CI 0.60–1.29) or distant recurrence-free interval (HR 1.0, 95%CI 0.67–1.51) between the groups [ 6 ]. These findings add to the growing number of studies demonstrating the safety of radiotherapy omission in carefully selected patients whether using demographics, pathologic features, or imaging, and several studies are ongoing to refine further the identification of low-risk groups who can safely avoid radiotherapy [ [6] , [7] , [8] , [9] , [10] ].…”

Comparative analysis of machine learning models for breast cancer prediction and diagnosis: a dual-dataset approach

“…In our study, we use Minkowski distance and set n-neighbors = 5. The Minkowski distance metric equations are as (6).…”

“…GLOBOCAN 2020 data depicts the estimated number of new cases in women as 2.3 million, with 6.9% mortality over the five years respectively [3]. According to the LLR (log-linear Regression) model, women above the age of 75 are more likely to get Breast Cancer, followed by women between the ages of 55 and 64 [4]- [6].…”

Real-World Experience among Elderly Metastatic Breast Cancer Patients Treated with CDK4/6 Inhibitor-Based Therapy

“…This is despite the fact that elderly populations represent a large percentage of the newly diagnosed cases, with the majority of such cases being HR+ and HER2− presentations [20,21]. Recently, there has been an increased focus on specifically addressing the needs and outcomes of older breast cancer populations [22][23][24][25][26][27][28], with the European Society of Breast Cancer Specialists and the International Society of Geriatric Oncology recommending 70 years of age as an appropriate stratification point [29].…”