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An observational study investigating failure of primary endocrine therapy for operable breast cancer in the elderly

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Abstract

Background

Elderly patients are more likely to have oestrogen receptor positive cancers that can be treated without surgery with primary endocrine therapy (PET). Few studies have sought to identify predictors of failure of PET and so the aim of this study was to evaluate treatment failures in elderly breast cancer patients treated with PET and to determine predictors of failure.

Methods

A retrospective observational study was performed on consecutive patients with ER-positive early stage breast cancer treated with PET between 2005 and 2015 in the three breast units in the North East of England. The primary outcome measure was treatment failure and secondary outcome measure was disease progression.

Results

488 patients were included with mean follow-up 31 months (SD 23). Overall, 206 patients were still alive with their disease controlled at the end of follow-up, 219 had died with their disease controlled and 63 (12%) experienced treatment failure. Younger age [SHR 0.96 (95% CI 0.94–0.99) p 0.013], larger tumours [SHR 1.03 (1.01–1.06) p 0.015], grade 3 cancers [SHR 3.58 (1.93–6.63) p < 0.001] and axillary lymph node metastases [SHR 1.93 (1.06–3.52) p 0.030] were all independent predictors of treatment failure. Disease progression was reported in 86 (17.6%) of patients.

Conclusions

This is the largest retrospective series evaluating PET treatment failure. Clear predictors of failure have been identified, which can be used to facilitate treatment decision making. These results support previous analyses, further validating our results.

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Acknowledgements

There are no acknowledgements to make.

Funding

No external funding or sponsorship was received by any author for the conduct of the study.

Author information

Author notes

  1. Robert Thomas

    Present address: , 48 Larkspur Terrace, Jesmond, Newcastle upon Tyne, NE2 2DU, UK

Authors and Affiliations

  1. Queen Elizabeth Hospital, Gateshead, NE9 6SX, UK

    Robert Thomas

  2. Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, NE1 4LP, UK

    Rachel Rowell & Henry Cain

  3. Medical Research Council Clinical Trials Unit, University College London, Aviation House, 125 Kingsway, London, WC2B 6NH, UK

    Siobhan Crichton

Authors
  1. Robert Thomas
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Contributions

Author contribution

RT and HC were responsible for the study concepts and design. Data acquisition was performed by RT and RR. Data and statistical analysis were performed by SC. Manuscript preparation, editing and review were performed by RT, RR, SC and HC.

Corresponding author

Correspondence to Robert Thomas.

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Conflicts of interests

HC is on the Clinical Advisory board for Roche Products Limited and received Honorariums and travel expenses; no other relationships or activities exist for all other authors that could appear to have influenced the submitted work.

Ethical approval

No ethical approval was required for this retrospective study.

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Thomas, R., Rowell, R., Crichton, S. et al. An observational study investigating failure of primary endocrine therapy for operable breast cancer in the elderly. Breast Cancer Res Treat 167, 73–80 (2018). https://doi.org/10.1007/s10549-017-4494-z

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  • DOI: https://doi.org/10.1007/s10549-017-4494-z

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