The incidence and consequences of escape from hormonal manipulation in elderly breast cancer patients
Association of Breast Surgery ePoster Library. Mc Kiernan J. 05/15/17; 166272; P036
Dr. J Mc Kiernan
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Abstract
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Objective
Surgical resection is the cornerstone for breast cancer treatment. However, due to associated co-morbidities among the elderly breast cancer population (>75 years) primary hormonal manipulation (PHM) is more frequently used. While PHM can be effective for a number of years, treatment following tumour hormonal escape poses a dilemma in a subsequently more aged patient. The aim of this study was to assess primary management and determine the rate and consequences of hormonal escape in patients over 75 diagnosed with breast cancer.
Methods
New diagnoses of breast cancer (2010-2015) among patients aged >75 years were identified from a prospective MDT database. Patient records were reviewed for demographic, tumour and treatment details.
Results
A total of 502 patients were identified with an average age of 81.2 (range 75 -99). Surgery was the primary treatment in 49% of patients (n=246). A further 8% (n=38) did not receive any treatment. PHM was utilised in 43% (n=218). In the PHM group, 19% (41) underwent surgical intervention following progression due to tumour hormonal escape. Mastectomy was performed in 73% (n=30) of these compared with 39% (95) of those treated primarily with surgery.
Conclusions
In managing elderly patients with breast cancer, the high rate of tumour hormonal escape needs to be considered when recommending treatment. The consequence of hormonal escape is more invasive surgery in a subsequently more aged patient with almost double the mastectomy rate compared with those treated primarily with surgery.
Surgical resection is the cornerstone for breast cancer treatment. However, due to associated co-morbidities among the elderly breast cancer population (>75 years) primary hormonal manipulation (PHM) is more frequently used. While PHM can be effective for a number of years, treatment following tumour hormonal escape poses a dilemma in a subsequently more aged patient. The aim of this study was to assess primary management and determine the rate and consequences of hormonal escape in patients over 75 diagnosed with breast cancer.
Methods
New diagnoses of breast cancer (2010-2015) among patients aged >75 years were identified from a prospective MDT database. Patient records were reviewed for demographic, tumour and treatment details.
Results
A total of 502 patients were identified with an average age of 81.2 (range 75 -99). Surgery was the primary treatment in 49% of patients (n=246). A further 8% (n=38) did not receive any treatment. PHM was utilised in 43% (n=218). In the PHM group, 19% (41) underwent surgical intervention following progression due to tumour hormonal escape. Mastectomy was performed in 73% (n=30) of these compared with 39% (95) of those treated primarily with surgery.
Conclusions
In managing elderly patients with breast cancer, the high rate of tumour hormonal escape needs to be considered when recommending treatment. The consequence of hormonal escape is more invasive surgery in a subsequently more aged patient with almost double the mastectomy rate compared with those treated primarily with surgery.
Objective
Surgical resection is the cornerstone for breast cancer treatment. However, due to associated co-morbidities among the elderly breast cancer population (>75 years) primary hormonal manipulation (PHM) is more frequently used. While PHM can be effective for a number of years, treatment following tumour hormonal escape poses a dilemma in a subsequently more aged patient. The aim of this study was to assess primary management and determine the rate and consequences of hormonal escape in patients over 75 diagnosed with breast cancer.
Methods
New diagnoses of breast cancer (2010-2015) among patients aged >75 years were identified from a prospective MDT database. Patient records were reviewed for demographic, tumour and treatment details.
Results
A total of 502 patients were identified with an average age of 81.2 (range 75 -99). Surgery was the primary treatment in 49% of patients (n=246). A further 8% (n=38) did not receive any treatment. PHM was utilised in 43% (n=218). In the PHM group, 19% (41) underwent surgical intervention following progression due to tumour hormonal escape. Mastectomy was performed in 73% (n=30) of these compared with 39% (95) of those treated primarily with surgery.
Conclusions
In managing elderly patients with breast cancer, the high rate of tumour hormonal escape needs to be considered when recommending treatment. The consequence of hormonal escape is more invasive surgery in a subsequently more aged patient with almost double the mastectomy rate compared with those treated primarily with surgery.
Surgical resection is the cornerstone for breast cancer treatment. However, due to associated co-morbidities among the elderly breast cancer population (>75 years) primary hormonal manipulation (PHM) is more frequently used. While PHM can be effective for a number of years, treatment following tumour hormonal escape poses a dilemma in a subsequently more aged patient. The aim of this study was to assess primary management and determine the rate and consequences of hormonal escape in patients over 75 diagnosed with breast cancer.
Methods
New diagnoses of breast cancer (2010-2015) among patients aged >75 years were identified from a prospective MDT database. Patient records were reviewed for demographic, tumour and treatment details.
Results
A total of 502 patients were identified with an average age of 81.2 (range 75 -99). Surgery was the primary treatment in 49% of patients (n=246). A further 8% (n=38) did not receive any treatment. PHM was utilised in 43% (n=218). In the PHM group, 19% (41) underwent surgical intervention following progression due to tumour hormonal escape. Mastectomy was performed in 73% (n=30) of these compared with 39% (95) of those treated primarily with surgery.
Conclusions
In managing elderly patients with breast cancer, the high rate of tumour hormonal escape needs to be considered when recommending treatment. The consequence of hormonal escape is more invasive surgery in a subsequently more aged patient with almost double the mastectomy rate compared with those treated primarily with surgery.
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