Breast conservation in elderly women for clinically negative axillary lymph nodes without axillary dissection

• Published in: Cancer Vol. 74; no. 3; pp. 878 - 883
• Main Authors: Wazer, David E., Erban, John K., Robert, Nicholas J., Smith, Thomas J., Marchant, Douglas J., Schmid, Christopher, Dipetrillo, Thomas, Schmidt‐Ullrich, Rupert
• Format: Journal Article
• Language: English
• Published: New York Wiley Subscription Services, Inc., A Wiley Company 01.08.1994; Wiley-Liss
• Subjects: Age Factors; Aged; Aged, 80 and over; Axilla; axillary lymph node dissection; Biological and medical sciences; breast cancer; breast conservation; Breast Neoplasms - mortality; Breast Neoplasms - therapy; Combined Modality Therapy; elderly; Female; Follow-Up Studies; Gynecology. Andrology. Obstetrics; Humans; Lymph Nodes - pathology; Mammary gland diseases; Medical sciences; Neoplasm Staging; Prospective Studies; Survival Rate; Treatment Outcome; Tumors; Human; Antineoplastic agent; Carcinoma; Prognosis; Antiestrogen; Early stage; Malignant tumor; Antihormone; Radiotherapy; Tamoxifene; Mammary gland diseases; Chemotherapy; Surgery; Female; Combined treatment; Mammary gland; Elderly; Tumorectomy
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/1097-0142(19940801)74:3<878::AID-CNCR2820740314>3.0.CO;2-4

Background. A prospective study was initiated to explore an approach of limited therapy in elderly patients with early clinical stage breast cancer. Methods. Between 1982 and 1989, 73 women with American Joint Committee on Cancer Stage I/II, clinically negative axillary lymph nodes aged 65 years or older (median age, 74 years) were enrolled in a treatment program consisting of tumor excision, breast and regional lymph node irradiation, and, in 66 patients, tamoxifen. Patients were assessed for disease outcome and complications. Results. At a median follow‐up of 54 months, 8‐year rates of local and regional lymph node control were 92.5% and 100%, respectively. Eight‐year probabilities of disease free, overall, and breast cancer specific survival were 84%, 52.5%, and 93.8%, respectively. There was minimal morbidity associated with either regional irradiation or tamoxifen. Conclusions. An approach to early breast cancer in the elderly that seeks to limit the aggressiveness of local and systemic therapies appears to result in a satisfactory disease outcome with few complications.