Management of invasive operable breast cancer in the older patient - can we be more objective?
Association of Breast Surgery ePoster Library. Irvine E. 05/15/17; 166212; P032
Esmee Irvine
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Abstract
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Introduction: In the UK, 31% of breast cancers occur in the over 70 age group. As life expectancy is increasing, this figure will increase. There is a lack of an evidence based approach to the management of early breast cancer in the elderly. The aim of this study was to assess the factors influencing treatment strategies in this group of patients.
Methods: Between 2012-2013, 323 patients aged 70 and over were treated for invasive breast cancer. Patient factors including co-morbidities were used to calculate Charlson co-morbidity scores retrospectively; indications for surgery or primary endocrine therapy (PET) were recorded.
Results: Seventy three percent were diagnosed symptomatically. Surgical treatment was undertaken in 72% of patients with 28% having PET. Overall survival rate in the surgical group was 94% at two years and 60% in the PET group. Documented indications for PET included patients deemed unfit for surgery by the surgeon in 22 cases and by anaesthetist in 4 patients. Surgery was declined by 28 patients. The indications for PET were not clearly documented in 23 cases. Charlson co-morbidity scores were not significantly different between the surgery and the primary endocrine therapy group. In the surgical group 49% had wide local excision but 17% of these did not have radiotherapy.
Conclusion: Our data demonstrates a lack of consistency in the management of breast cancer in the elderly. The use of objective scoring systems will support standardised approaches to care. Bridging the Age Gap study will help develop objective tools for making treatment decisions.
Methods: Between 2012-2013, 323 patients aged 70 and over were treated for invasive breast cancer. Patient factors including co-morbidities were used to calculate Charlson co-morbidity scores retrospectively; indications for surgery or primary endocrine therapy (PET) were recorded.
Results: Seventy three percent were diagnosed symptomatically. Surgical treatment was undertaken in 72% of patients with 28% having PET. Overall survival rate in the surgical group was 94% at two years and 60% in the PET group. Documented indications for PET included patients deemed unfit for surgery by the surgeon in 22 cases and by anaesthetist in 4 patients. Surgery was declined by 28 patients. The indications for PET were not clearly documented in 23 cases. Charlson co-morbidity scores were not significantly different between the surgery and the primary endocrine therapy group. In the surgical group 49% had wide local excision but 17% of these did not have radiotherapy.
Conclusion: Our data demonstrates a lack of consistency in the management of breast cancer in the elderly. The use of objective scoring systems will support standardised approaches to care. Bridging the Age Gap study will help develop objective tools for making treatment decisions.
Introduction: In the UK, 31% of breast cancers occur in the over 70 age group. As life expectancy is increasing, this figure will increase. There is a lack of an evidence based approach to the management of early breast cancer in the elderly. The aim of this study was to assess the factors influencing treatment strategies in this group of patients.
Methods: Between 2012-2013, 323 patients aged 70 and over were treated for invasive breast cancer. Patient factors including co-morbidities were used to calculate Charlson co-morbidity scores retrospectively; indications for surgery or primary endocrine therapy (PET) were recorded.
Results: Seventy three percent were diagnosed symptomatically. Surgical treatment was undertaken in 72% of patients with 28% having PET. Overall survival rate in the surgical group was 94% at two years and 60% in the PET group. Documented indications for PET included patients deemed unfit for surgery by the surgeon in 22 cases and by anaesthetist in 4 patients. Surgery was declined by 28 patients. The indications for PET were not clearly documented in 23 cases. Charlson co-morbidity scores were not significantly different between the surgery and the primary endocrine therapy group. In the surgical group 49% had wide local excision but 17% of these did not have radiotherapy.
Conclusion: Our data demonstrates a lack of consistency in the management of breast cancer in the elderly. The use of objective scoring systems will support standardised approaches to care. Bridging the Age Gap study will help develop objective tools for making treatment decisions.
Methods: Between 2012-2013, 323 patients aged 70 and over were treated for invasive breast cancer. Patient factors including co-morbidities were used to calculate Charlson co-morbidity scores retrospectively; indications for surgery or primary endocrine therapy (PET) were recorded.
Results: Seventy three percent were diagnosed symptomatically. Surgical treatment was undertaken in 72% of patients with 28% having PET. Overall survival rate in the surgical group was 94% at two years and 60% in the PET group. Documented indications for PET included patients deemed unfit for surgery by the surgeon in 22 cases and by anaesthetist in 4 patients. Surgery was declined by 28 patients. The indications for PET were not clearly documented in 23 cases. Charlson co-morbidity scores were not significantly different between the surgery and the primary endocrine therapy group. In the surgical group 49% had wide local excision but 17% of these did not have radiotherapy.
Conclusion: Our data demonstrates a lack of consistency in the management of breast cancer in the elderly. The use of objective scoring systems will support standardised approaches to care. Bridging the Age Gap study will help develop objective tools for making treatment decisions.
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