- Local recurrence-free survival (RFS) is worst in patients age >70 years with early breast cancer who do not receive adjuvant therapy.
Why this matters
- Breast cancer is increasing among patients age >65 years.
- Omission of adjuvant therapy after breast-conserving surgery in low-risk patients (>70 years) is controversial.
- These results suggest that some form of adjuvant therapy (radiation alone, endocrine alone, or both) is more advisable.
- Retrospective cohort study of 460 patients (age >70 years with early breast cancer) in the Nova Scotia Cancer Registry database.
- Primary outcome: local RFS.
- Funding: None.
- Vs no adjuvant therapy, local RFS was higher in patients receiving adjuvant therapy:
- No adjuvant therapy: 88.0% at 5 years and 84.6% at 10 years.
- Endocrine: 95.8% and 95.8%.
- Radiation: 98.5% and 94.8%.
- Both: 99.2% and 99.2%.
- All P<.05 vs no adjuvant.>
- On multivariate analysis, RFS (HRs) was lower with no adjuvant vs:
- Endocrine therapy (±radiation therapy): 3.4 (P=.03).
- Radiation therapy (±endocrine therapy): 4.1 (P=.02).
- Vs no adjuvant therapy, 5-year local-regional RFS was higher (all, P<.05 adjuvant therapy:>
- No adjuvant therapy: 86.8%.
- Endocrine alone: 94.4%.
- Radiation alone: 98.5%.
- Both: 97.5%.
- Retrospective, observational.