Journal of Clinical & Experimental OncologyISSN: 2324-9110

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Research Article, J Clin Exp Oncol Vol: 3 Issue: 1

Impact of Loco-Regional Undertreatment in Elderly Patients with Early Breast Cancer (Protocol Yameka-09sdlt); Multi-Centric Retrospective Cohort Study

Can Atalay1*, Sertac Ata Guler2, Derya Selamoglu3, Vahit Ozmen4, Erol Aksaz5, Turgay Simsek6, Zafer Canturk N6, Ulvi Meral7, Semih Gorgulu7, Evrim Kallem8, Serdar Ozbas8, Semiha Sen L2 and Bahadir M Gulluoglu2
1Department of General Surgery, Ankara Oncology Hospital, Ankara, Turkey
2Breast and Endocrine Surgery Unit, Department of General Surgery, Marmara University School of Medicine, ─░stanbul, Turkey
3General Surgery Unit, Florance Nightingale Metropolitan Hospital, ─░stanbul, Turkey
4Breast Surgery Unit, Department of General Surgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
5MAMER Breast Center, Bursa, Turkey
6Breast and Endocrine Surgery Unit, Department of General Surgery, Kocaeli University School of Medicine, Kocaeli, Turkey
7Department of General Surgery, Gulhane Military Medical Academy, Ankara, Turkey
8Department of General Surgery, Adnan Menderes University School of Medicine, Aydin, Turkey
Corresponding author : Can Atalay
Department of General Surgery, Ankara Oncology Hospital, Ankara, Turkey
E-mail: [email protected]
Received: November 04, 2013 Accepted: February 18, 2014 Published: February 24, 2014
Citation: Atalay C, Guler SA, Selamoglu D, Ozmen V, Aksaz E, et al., (2014) Impact of Loco-Regional Under-treatment in Elderly Patients with Early Breast Cancer (Protocol Yameka-09sdlt);Multi-Centric Retrospective Cohort Study. J Clin Exp Oncol 3:1. doi:10.4172/2324-9110.1000118

Abstract

Impact of Loco-Regional Undertreatment in Elderly Patients with Early Breast Cancer (Protocol Yameka-09sdlt); Multi-Centric Retrospective Cohort Study

Elderly breast cancer patients are generally excluded from clinical trials and non-standard treatments are administered more in this group of patients. Aim of the study is to assess the impact of non-standard locoregional treatment on survival in elderly patients with clinically early stage breast cancer. Patients over 70 years of age operated for a unilateral, early stage breast cancer between 1998 and 2009 were retrospectively included in the study. Patient and tumor characteristics were recorded. Adjuvant treatments, last date of follow-up and recurrences and/or death were recorded. Treatments without radiotherapy after breast conserving therapy, without sentinel lymph node biopsy or axillary dissection, without axillary dissection or axillary radiotherapy in case of a positive sentinel lymph node and without radiotherapy in the presence of ≥ 4 positive lymph nodes were regarded as loco-regional under-treatment. Disease-free, breast cancer-specific and overall survival of patients who received standard and non-standart loco-regional treatments were compared. 384 patients with a median age of 74 were included in the study. Median tumor size was 25 mm. Non-standard loco-regional treatment was applied in 90 (23.4%) patients. Most commonly omitted was axillary treatment. Patients with 3 or more associated diseases significantly received less standard loco-regional treatment. Median follow-up period was 35 months and, during follow-up, 10.4% of patients had recurrence whereas 13% of patients died. Although disease-free survival were similar in both groups, overall and breast cancer-specific survivals were significantly less in those who received non-standart locoregional treatment. As number of associated diseases reaches three or more, there was a strong tendency to administer less standard locoregional treatment. Most commonly, patients did not undergo axillary staging or treatment. Although loco-regional under-treatment resulted poorer overall and breast cancer-specific survival, disease free survival was not different in those elderly early stage breast cancer patients who received adequate treatment. Short follow-up time should be kept in mind while evaluating the results of the current study.

Keywords: Elderly; Breast cancer; Under-treatment; Loco-regional treatment; Survival

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