Abstract 114P
Background
The risk of developing Breast Cancer (BC) increases with age with half of all cases of new onset BC occurring in women older than 65 years of age, and more than 30% occurring after the age of 75 years. Breast surgery is a safe procedure with clear oncological benefit recommended for elderly patients, indeed axillary management is not routinely recommended for these elderly patients. This study evaluated axillary surgery (AS) trends over a 10-year follow-up period as well as locoregional and survival outcomes for elderly woman.
Methods
Information regarding 1.748 consecutive elderly patients (range age 70-84 years old) operated for a first primary invasive BC at the European Institute of Oncology between 1994 and 2008, were selected and divided in two groups, depending on whether or not AS was performed. A (1:1) matched analysis for all relevant clinicopathological features was performed. Outcomes were analyzed using the Kaplane Meier method and univariate Cox-proportional hazard ratio analysis.
Results
A total of 1.748 patients were identified and stratified by age (70-74, 75-79, 80-84). A matched analysis was performed for 252 patients: 122 who underwent AS and 122 who did not. At 10-year followup, ipsilateral breast tumor recurrence, distant metastasis and contralateral BC were similar, p < 0.83, p < 0.42 and p < 0.28, respectively. In the no-AS group, a significant increased risk of axillary lymphnode recurrence was identified at 5- and confirmed at 10-years (p < 0.038), without impact on overall survival at 5- and 10-years (p < 0.52). In the non-AS group, higher rate of axillary recurrence at 10-years was observed in patients with poorly differentiated (24.1%, 95% CI 7.2-46.2), highly proliferative (Ki67 20%: 17.1%, 95% CI 0.6-33.3) and luminal B tumors (16.8%, 95% CI 5.9-35.5).
Conclusions
Axillary staging in elderly women does not impact long-term survival. Tailoring surgery according to tumor biology and age may improve locoregional outcome.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.