Many elderly breast cancer patients should be considered for more intensive treatment than is currently offered, researchers have found.
Women with breast cancer aged over 70 years have worse survival rates than younger patients – and this may be concerns about age lead to them receiving less treatment than others.
So Professor Lynda Wyld at the University of Sheffield, UK, and colleagues analysed information on 2,979 women whose cancer was driven by the oestrogen hormone.
Of these women, 82% were treated with surgery and 18% with anti-oestrogen tablets only.
The tablet-only group were an average of eight years older and significantly less fit than the surgery group. Overall survival was 42% for women on tablets only compared to 15% who had surgery. Death rates specifically from breast cancer were 10% in the tablet-only group compared to 5% in the surgery group.
Details will be presented on Friday (2 October) at the 12th European Breast Cancer Conference, held online.
Professor Wyld says: “For most women, surgery is well tolerated and should be the aim of treatment if possible, as we have shown that survival rates are slightly lower in women who do not have surgery.
“However, when we looked at the two treatments in a less fit group of older women, these differences in breast cancer survival disappeared.”
She added that, in less fit older women, “their quality of life and their ability to engage in everyday activities deteriorated more after surgery”.
“This also must be weighed up against the potential difference in survival between surgery and primary hormone therapy,” she believes.
The team went on to develop an online decision-making tool to determine whether older women will benefit from surgery or not, available at https://agegap.shef.ac.uk/
Abstract no: 8, Bridging the age gap in breast cancer. Impacts of omission of breast cancer surgery in older women with ER+ early breast cancer. A risk stratified analysis of survival and quality of life outcomes. Presented on Friday 2 October 2020 at EBCC12.
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