Lumpectomy Plus Hormone or Radiation Therapy Alone for Women Aged 70 Years or Older With Hormone Receptor-Positive Early Stage Breast Cancer in the Modern Era: An Analysis of the National Cancer Database

International Journal of Radiation Oncology, Biology, Physics
Samantha M BuszekSimona F Shaitelman

Abstract

Deintensification of adjuvant therapy is being considered for older women with early-stage, biologically favorable breast cancer. Although radiation therapy (RT) can be omitted in some cases, toxicity from hormone therapy (HT) is not trivial, and adherence rates vary. We hypothesized that adjuvant RT alone would produce survival outcomes comparable to those with adjuvant HT alone among elderly patients treated with lumpectomy. We searched the National Cancer Database (2010-2014) for healthy women (aged ≥70 years, Charlson/Deyo [CD] score 0-1) with T1N0 hormone-receptor-positive, HER-2-negative breast cancer treated with lumpectomy and adjuvant HT or RT. Propensity scores were used to match patients for analysis. We identified 2995 patients (median age, 78 years), most (81%) with a CD score of 0, clinical stage IA (77%), of whom 65% received HT alone and 35% received RT only after lumpectomy. On multivariate analysis of the matched cohort, older age (hazard ratio [HR] 1.10; 95% confidence interval [CI] 1.07-1.13; P < .001), CD score 1 (HR 1.92; 95% CI 1.37-2.70; P = .0002), and living in a metropolitan (vs urban) area (HR 3.09; 95% CI 1.43-6.67; P = .004) were associated with inferior overall survival (OS), whereas treatment wit...Continue Reading

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Citations

Jun 11, 2020·F1000Research·Isacco DesideriLorenzo Livi
Jan 3, 2021·Current Oncology Reports·Ammoren DohmRonica H Nanda
Sep 18, 2020·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Kurian JosephKaren King
Jul 24, 2020·International Journal of Radiation Oncology, Biology, Physics·Chirag ShahTrevor J Royce
Oct 16, 2021·JCO Oncology Practice·Chirag ShahFrank Vicini

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