Low Axillary Recurrence/Mortality Among Older Women With Node-Negative Breast Cancer Undergoing Breast-Conserving Surgery Without Sentinel Node Biopsy
In a single institution study reported in JAMA Surgery, Chung et al found a low axillary recurrence rate and low mortality among women with clinical T1–2N0 breast cancer aged ≥ 70 years who underwent breast-conserving surgery without sentinel node biopsy.
Study Details
The study involved 140 women treated at Cedars-Sinai Medical Center between January 2000 and December 2011. Patients had a median age of 83 years (range = 70–97 years); 74% had T1 tumors; 27% had grade 1, 44% grade 2, and 29% grade 3 tumors; 86% were estrogen receptor–positive; 73% were progesterone receptor–positive; 92% were HER2-negative; and 65% had ductal histology. Overall, 98% received chemotherapy, 76% radiotherapy, and 59% hormonal therapy.
Outcomes
Median follow-up was 4.5 years. Overall, five patients (4%) experienced a breast cancer–related event. One had axillary recurrence (estrogen receptor–, progesterone receptor–, and HER2-negative tumor). Four died of breast cancer: two with estrogen receptor–, progesterone receptor–, and HER2-negative disease, one with estrogen receptor– and HER2-negative and progesterone receptor–positive disease, and one with estrogen receptor– and HER2-positive and progesterone receptor–negative disease. The 5-year overall survival rate was 70%, and the 5-year breast cancer–specific survival rate was 96%.The most common cause of death was ischemic heart disease. Tumor size was the only factor significantly associated with survival.
The investigators concluded: “Our study demonstrated low axillary recurrence and low mortality for patients with clinical T1–2N0 breast cancer who were 70 years of age or older and who underwent breast-conserving surgery without a sentinel node biopsy.”
Alice Chung, MD, of Cedars-Sinai Medical Center, is the corresponding author for the JAMA Surgery article.
The study was supported by Margie and Robert E. Petersen Foundation and Fashion Footwear Charitable Foundation of New York.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
