Primary endocrine therapy as a treatment for older women with operable breast cancer - a comparison of randomised controlled trial and cohort study findings

Morgan, J L, Reed, M W and Wyld, L (2014) Primary endocrine therapy as a treatment for older women with operable breast cancer - a comparison of randomised controlled trial and cohort study findings. European Journal of Surgical Oncology, 40 (6). pp. 676-684. ISSN 0748-7983

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Abstract

Introduction: One third of all breast cancers occur in women over the age of 70. Primary endocrine therapy (PET) is used in some women to minimise morbidity in a population with higher rates of comorbidity and frailty. In the UK up to 40 of women over 70 are treated with PET although there is a high rate of variability of practice between centres reflecting a lack of guidance about case selection. Methods: A systematic review of the literature was performed to try and establish if this form of treatment is still valid in modern breast practice. Results: Six randomised controlled trials (RCTs) and 31 non-randomised studies were deemed eligible. Available data demonstrate an advantage for surgery over PET in terms of disease control and a likely survival benefit in patients with a predicted life expectancy of five years or more. Patients treated only with aromatase inhibitors (AIs) had superior rates of disease control when compared to Tamoxifen. Conclusions: Guidelines to aid selection are needed but PET should be reserved for patients with reduced predicted life expectancy (e.g. less than five years), with AIs being preferable over Tamoxifen. © 2013 Elsevier Ltd. All rights reserved.

Item Type: Article
Schools and Departments: Brighton and Sussex Medical School > Brighton and Sussex Medical School
Subjects: R Medicine
Depositing User: Esme Acton-Stewart
Date Deposited: 18 Jan 2016 15:54
Last Modified: 18 Jan 2016 15:54
URI: http://sro.sussex.ac.uk/id/eprint/57944
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