Lani
01-21-2008, 10:55 AM
This study did not test for her2, but did test for ER and PR (although er-pr- patients were included AND given tamoxifen!) It included all tumor sizes, but patients over 70 most often had smaller tumors (they tend to grow less quickly in older women) Those who did poorly tended to be ER-PR- which included her2+ and her2-s we assume. Only one patient was ER+PR- which is felt to be a sign of increased growth factor activity ie, EGFR+ or her2+
Is TOM OUT THERE LURKING?:
Elderly breast cancer patients treated by conservative surgery alone plus adjuvant tamoxifen: Fifteen-year results of a prospective study.
Martelli G, Miceli R, Costa A, Coradini D, Zurrida S, Piromalli D, Vetrella G, Greco M.
Breast Unit, National Cancer Institute, Milan, Italy.
BACKGROUND.: In elderly patients with early breast cancer and a clinically clear axilla, axillary surgery, sentinel lymph node biopsy, and postoperative radiotherapy to the residual breast may not be necessary because of reduced life expectancy, effectiveness of hormone therapy in achieving long-term disease control, and generally favorable biologic behavior of breast cancer in elderly patients. METHODS.: The authors followed 354 prospectively recruited women aged >/=70 years who had primary, operable breast cancer and no palpable axillary lymph nodes. All 354 women were treated with conservative surgery and adjuvant tamoxifen and without axillary dissection or postoperative radiotherapy. Women who had resection margins in tumor tissue were excluded. Endpoints were cumulative incidence of axillary disease, cumulative incidence of ipsilateral breast tumor recurrence (IBTR), and breast cancer mortality. RESULTS.: After a median follow-up of 15 years (interquartile range, 14-17 years), the crude cumulative incidence was 4.2% (4% in pathologic T1 [pT1] tumors) for axillary disease, 8.3% (7.3% in pT1 tumors) for IBTR, and 17% for breast cancer mortality. Of the 268 patients who died during follow-up, 222 patients (83%) died from causes unrelated to breast cancer. CONCLUSIONS.: Elderly patients with early breast cancer and no palpable axillary lymph nodes may be safely treated safety by conservative surgery without axillary dissection and without postoperative radiotherapy, provided that surgical margins are in tumor-free tissue and that hormone therapy is administered. Sentinel lymph node biopsy is also unnecessary because of the low cumulative incidence of axillary disease, and axillary surgery can be reserved for the small proportion of patients who later develop overt axillary disease. Cancer 2008. (c) 2007 American Cancer Society.
PMID: 18098268 [PubMed - as supplied by publisher]
Is TOM OUT THERE LURKING?:
Elderly breast cancer patients treated by conservative surgery alone plus adjuvant tamoxifen: Fifteen-year results of a prospective study.
Martelli G, Miceli R, Costa A, Coradini D, Zurrida S, Piromalli D, Vetrella G, Greco M.
Breast Unit, National Cancer Institute, Milan, Italy.
BACKGROUND.: In elderly patients with early breast cancer and a clinically clear axilla, axillary surgery, sentinel lymph node biopsy, and postoperative radiotherapy to the residual breast may not be necessary because of reduced life expectancy, effectiveness of hormone therapy in achieving long-term disease control, and generally favorable biologic behavior of breast cancer in elderly patients. METHODS.: The authors followed 354 prospectively recruited women aged >/=70 years who had primary, operable breast cancer and no palpable axillary lymph nodes. All 354 women were treated with conservative surgery and adjuvant tamoxifen and without axillary dissection or postoperative radiotherapy. Women who had resection margins in tumor tissue were excluded. Endpoints were cumulative incidence of axillary disease, cumulative incidence of ipsilateral breast tumor recurrence (IBTR), and breast cancer mortality. RESULTS.: After a median follow-up of 15 years (interquartile range, 14-17 years), the crude cumulative incidence was 4.2% (4% in pathologic T1 [pT1] tumors) for axillary disease, 8.3% (7.3% in pT1 tumors) for IBTR, and 17% for breast cancer mortality. Of the 268 patients who died during follow-up, 222 patients (83%) died from causes unrelated to breast cancer. CONCLUSIONS.: Elderly patients with early breast cancer and no palpable axillary lymph nodes may be safely treated safety by conservative surgery without axillary dissection and without postoperative radiotherapy, provided that surgical margins are in tumor-free tissue and that hormone therapy is administered. Sentinel lymph node biopsy is also unnecessary because of the low cumulative incidence of axillary disease, and axillary surgery can be reserved for the small proportion of patients who later develop overt axillary disease. Cancer 2008. (c) 2007 American Cancer Society.
PMID: 18098268 [PubMed - as supplied by publisher]