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Am J Surg. 2017 Dec;214(6):1082-1088. doi: 10.1016/j.amjsurg.2017.07.036. Epub 2017 Sep 18.

Does lymph node status influence adjuvant therapy decision-making in women 70 years of age or older with clinically node negative hormone receptor positive breast cancer?

Author information

1
Department of Surgery, Yale University School of Medicine, New Haven, CT, USA. Electronic address: Anees.chagpar@yale.edu.
2
Department of Surgery, Yale University School of Medicine, New Haven, CT, USA.
3
Department of Medicine (Medical Oncology), Yale University School of Medicine, New Haven, CT, USA.
4
Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT, USA.

Abstract

BACKGROUND:

Women ≥70 years old with clinically (c) lymph node (LN) negative (-), hormone receptor (HR) positive (+) breast cancer are recommended not to be routinely staged with a sentinel LN biopsy. We sought to determine how this affects adjuvant decision-making.

METHODS:

Statistical analyses were performed to determine the association of LN evaluation with adjuvant chemotherapy and radiation therapy in cLN-, HR + breast cancer patients in the National Cancer Database.

RESULTS:

Between 2004 and 2013, there were 193,728 patients aged 70-90 with cLN-, HR + breast cancer; 15.0% were LN+. LN + patients were more likely to receive chemotherapy (28.3% vs. 5.5%, p < 0.001), hormonal therapy (83.6% vs. 71.4%, p < 0.001), post-lumpectomy radiation therapy (81.4% vs. 73.6%, p < 0.001) and post-mastectomy radiation therapy (30.3% vs. 5.1%, p < 0.001).

CONCLUSION:

15% of patients aged 70-90 will be LN+. These patients more frequently receive systemic and radiation therapy. LN status may affect treatment in these patients.

KEYWORDS:

Adjuvant therapy; Axilla; Breast cancer; Elderly; Sentinel node biopsy

PMID:
28939252
DOI:
10.1016/j.amjsurg.2017.07.036
[Indexed for MEDLINE]

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