Olga Kantor1, Catherine Pesce2, Erik Liederbach2, Chi-Hsiung Wang3, David J Winchester2, Katharine Yao4. 1. Department of Surgery, University of Chicago, Chicago, IL, USA. 2. Department of Surgery, NorthShore University HealthSystem, Evanston Hospital, Evanston, IL, USA. 3. Center for Biomedical Research Informatics, Research Institute, NorthShore University Health System, Evanston, IL, USA. 4. Department of Surgery, NorthShore University HealthSystem, Evanston Hospital, Evanston, IL, USA. Electronic address: kyao@northshore.org.
Abstract
BACKGROUND: There has been a trend toward minimizing surgery in elderly women with estrogen receptor-positive (ER+) breast cancer. METHODS: Using the National Cancer Data Base, we selected 95,357 women ≥80 years with invasive, ER+ breast cancer. Chi-square test and logistic regression were used to analyze trends in surgery and hormone therapy. RESULTS: From 2004 to 2012, 90% of women were treated with surgery first and 10% were treated with primary nonoperative management. Of those undergoing nonoperative management, 72% received endocrine therapy and 27% had no treatment. The rate of primary nonoperative treatment doubled from 7% in 2004 to 14% in 2012. Multivariate logistic regression adjusted for patient, facility, and tumor factors identified more advanced clinical stage, older age, African-American race, and treatment at Academic facilities as independent predictors of receiving primary nonsurgical management. CONCLUSIONS: There has been an increase over time in primary nonoperative management of ER+ breast cancer in octogenarians.
BACKGROUND: There has been a trend toward minimizing surgery in elderly women with estrogen receptor-positive (ER+) breast cancer. METHODS: Using the National Cancer Data Base, we selected 95,357 women ≥80 years with invasive, ER+ breast cancer. Chi-square test and logistic regression were used to analyze trends in surgery and hormone therapy. RESULTS: From 2004 to 2012, 90% of women were treated with surgery first and 10% were treated with primary nonoperative management. Of those undergoing nonoperative management, 72% received endocrine therapy and 27% had no treatment. The rate of primary nonoperative treatment doubled from 7% in 2004 to 14% in 2012. Multivariate logistic regression adjusted for patient, facility, and tumor factors identified more advanced clinical stage, older age, African-American race, and treatment at Academic facilities as independent predictors of receiving primary nonsurgical management. CONCLUSIONS: There has been an increase over time in primary nonoperative management of ER+ breast cancer in octogenarians.
Authors: Margaret E Smith; C Ann Vitous; Tasha M Hughes; Sarah P Shubeck; Reshma Jagsi; Lesly A Dossett Journal: Ann Surg Oncol Date: 2020-03-02 Impact factor: 5.344
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