Determinants of outcome in elderly patients with positive sentinel lymph nodes
Received 23 September 2009; received in revised form 23 January 2010 published online 09 July 2010. Corrected Proof
Abstract
Background
Older women are less likely to receive standard of care treatment for breast cancer.
Methods
We examined variables that affected the outcome of elderly patients ≥70 years old among 1,470 patients with invasive cancer with positive sentinel lymph nodes (SLNs).
Results
Elderly patients were less likely to undergo mastectomy, completion axillary node dissection (ALND), adjuvant chemotherapy, and radiotherapy (RT) following breast-conserving therapy (BCT) compared with patients <70 years old. The 5-year risk of disease progression and cumulative incidence of breast cancer–specific deaths were not significantly different for both groups. On multivariate analysis, hormone receptor–negative status, number of metastatic lymph nodes, high nuclear grade, and tumor size were the factors independently associated with increased risk of disease progression.
Conclusions
Tumor factors were the primary determinants of breast cancer outcomes in our cohort. Elderly patients are less likely to receive aggressive surgical interventions and adjuvant therapy because of perceived life expectancy.
aBreast Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, Evelyn H. Lauder Breast Center, 300 E. 66th St, New York, NY 10065, USA
bDepartment of Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
cDepartment of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
dDepartment of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
ABSTRACT