eBCa: post-BCS RT common in elderly despite lack of benefit

  • Downs-Canner S & al.
  • Ann Surg Oncol
  • 8 Feb 2019

  • curated by Miriam Davis, PhD
  • Univadis Clinical Summaries
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Takeaway

  • In a real-world cohort, usage of adjuvant radiotherapy (ART) was high, despite lack of OS benefit, in women ≥70 years of age with T1, estrogen receptor positive (ER+) tumors who had undergone breast-conserving surgery (BCS).
  • Neither having risk factors for local recurrence nor the estimated risk of death in 10 years was related to receipt of ART.

Why this matters

  • Findings suggest that this patient population is overtreated with ART.

Study design

  • Real-world database cohort (n=323) of women ≥70 years with ER+ T1 early breast cancer (eBCa) at Memorial Sloan Kettering Cancer Center (2010-2012).
  • Funding: NIH.

Key results

  • 53.8% of cohort received ART.
    • RT usage decreased at older ages, with those receiving ART being younger than those who did not (74 vs 78 years; P<.0001>
  • Median age of cohort: 75 years; median tumor size, 1 cm; all clinically node-negative.
  • These factors were not associated with ART usage:
    • estimated risk of death in 10 years;
    • having comorbidities; and
    • risk factors for local recurrence.
  • ART usage (vs no usage) did not significantly influence OS (92% vs 85%; P=.051).

Limitations

  • Single-center, nonrandomized design.

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