Surgery versus endocrine therapy for elderly women with oestrogen receptor (ER) positive early operable breast cancer - survival analysis and correlation with oestrogen receptor positivity

2009 ◽  
Vol 35 (11) ◽  
pp. 1201 ◽  
Author(s):  
Binafsha Syed ◽  
S. Johnston ◽  
D. Wong ◽  
D. Morgan ◽  
I. Ellis ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Survival Analysis ◽  
Endocrine Therapy ◽  
Oestrogen Receptor ◽  
Cancer Survival ◽  
Elderly Women ◽  
Operable Breast Cancer ◽  
Breast Cancer Survival ◽  
Er Positive

Surgery versus primary endocrine therapy for elderly women with estrogen receptor-positive early operable primary breast cancer: Survival analysis and correlation with oestrogen receptor positivity

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 612-612
Author(s):  
B. M. Syed ◽  
S. J. Johnston ◽  
D. W. M. Wong ◽  
D. A. L. Morgan ◽  
I. O. Ellis ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Endocrine Therapy ◽  
Primary Breast Cancer ◽  
Oestrogen Receptor ◽  
Elderly Women ◽  
Breast Cancer Specific Survival ◽  
Cancer Specific Survival ◽  
Er Positive ◽  
Primary Endocrine Therapy

612 Background: A recent Cochrane review of seven randomised trials involving 1,446 elderly women (unselected for oestrogen receptor (ER) status) has shown no significant difference in overall survival between surgery (with or without adjuvant tamoxifen) and primary endocrine therapy using tamoxifen. We now report results of a large series from a single centre with a dedicated elderly breast cancer service, with long term follow-up. Methods: During a period of > 20 years, 1,031 elderly (> 70 years) women with ER positive (H-score >50) early operable primary breast cancer received either surgery (with or without adjuvant endocrine therapy) (N = 436) or primary endocrine therapy (N = 595) (>80% using tamoxifen) as initial treatment, with complete follow-up information till deaths. The initial treatment was decided based on fitness for surgery and patient choice. Analysis was carried out on breast cancer specific survival and degree of ER positivity. Results: After a median follow up of 49 months (range 0 - 261 months), patients between 70 - 80 years, treated by surgery, had better 5-year breast cancer specific survival compared to their counterparts treated by primary endocrine therapy (95% versus 85%; p < 0.001). For patients > 80 years, there was however no statistical difference between the two groups (90% versus 90%; p = 0.813). The median survival has not reached yet in all groups. Patients in the latter group (> 80 years) were found to have a higher chance of having strongly ER positive tumours (57% versus 50% in patients between 70 - 80 years with H-score >200; p- < 0.02). Conclusions: In a selected group of elderly women (> 80 years) who tend to have strongly ER positive tumours, surgery and primary endocrine therapy did not appear to produce any difference in breast cancer specific survival. This subject is currently being investigated in a national randomised trial in the UK. No significant financial relationships to disclose.

scholarly journals Role of Detection Method in Predicting Breast Cancer Survival: Analysis of Randomized Screening Trials

2005 ◽  
Vol 97 (16) ◽  
pp. 1195-1203 ◽  
Author(s):  
Yu Shen ◽  
Ying Yang ◽  
Lurdes Y. T. Inoue ◽  
Mark F. Munsell ◽  
Anthony B. Miller ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Survival Analysis ◽  
Cancer Survival ◽  
Detection Method ◽  
Breast Cancer Survival ◽  
Screening Trials

scholarly journals Time-varying effects of prognostic factors associated with long-term survival in breast cancer

2018 ◽  
Vol 25 (5) ◽  
pp. 509-521 ◽  
Author(s):  
Minlu Zhang ◽  
Peng Peng ◽  
Kai Gu ◽  
Hui Cai ◽  
Guoyou Qin ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Cancer Survival ◽  
Tumour Size ◽  
Breast Cancer Survival ◽  
Lymph Node Status ◽  
Time Varying ◽  
Term Survival ◽  
Er Positive ◽  
The Impact

The impact of some prognostic factors on breast cancer survival has been shown to vary with time since diagnosis. However, this phenomenon has not been evaluated in Asians. In the present study, 4886 patients were recruited from the Shanghai Breast Cancer Survival Study, a longitudinal study of patients diagnosed during 2002–2006, with a median follow-up time of 11.2 years. Cox model incorporating time-by-covariate interactions was used to describe the time-varying effects of prognostic factors related to overall survival and disease-free survival. Age ≥65 years showed a progressively negative effect on breast cancer prognosis over time, whereas tumour size >2 cm had a lasting and constant impact. Age significantly modified the effects of the tumour grade, nodal status and oestrogen receptor (ER) status on breast cancer survival. The detrimental effect of poorly differentiated tumours was time limited and more obvious in patients aged 45–54 years. Having ≥4 positive lymph nodes had a persistent and negative impact on prognosis, although it attenuated in later years; the phenomenon was more prominent in the 55–64-year age group. ER-positive status was protective in the first 3 years after diagnosis but was related to a higher risk of recurrence in later years; the time-point when ER-positive status turned into a risk factor was earlier in younger patients. These results suggest that older age, positive lymph node status, larger tumour size and ER-positive status are responsible for late death or recurrence in Asian breast cancer survivors. Extended endocrine therapy should be given earlier in younger ER-positive patients.

Sign in / Sign up

Export Citation Format

Share Document