Purpose:
Standard therapy for breast cancer after breast‑conserving surgery is radiation therapy (RT) plus hormone therapy (HT). For patients with a low risk of recurrence, there is an interest in de‑escalating therapy.
Methods and Materials:
A retrospective study was carried out for patients treated at the Swedish Cancer Institute from 2000 to 2015, aged 70 years or older, with pT1N0 or pT1NX estrogen receptor‑positive and ERBB2‑negative unifocal breast cancer without positive surgical margins, high nuclear grade, or lymphovascular invasion.
Conclusions:
Our data suggest that elderly, low‑risk breast cancer patients have similarly high OS and PFS, with low rates of local recurrence, distant recurrence, and death from breast cancer, but with much higher rates of death from competing causes, whether treated with RT or HT + RT. These patients are likely to die of other causes without disease recurrence, regardless of which of these treatments is used. Thus, they may benefit from the administration of more modern forms of breast irradiation without the need for adjuvant systemic hormone therapy. A detailed analysis of which clinical, pathologic, genomic, and comorbidity variables are needed to select these patients.
Used by permission: Henry G. Kaplan, MD; Lead Researcher at Paul G. Allen Research Center at Swedish Cancer Institute