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Primary endocrine therapy as a treatment for older women with operable breast cancer - a comparison of randomised controlled trial and cohort study findings
journal contribution
posted on 2023-06-08, 23:10 authored by J L Morgan, Malcolm ReedMalcolm Reed, L WyldIntroduction: 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.
History
Publication status
- Published
Journal
European Journal of Surgical OncologyISSN
0748-7983Publisher
ElsevierExternal DOI
Issue
6Volume
40Page range
676-684Department affiliated with
- BSMS Publications
Full text available
- No
Peer reviewed?
- Yes
Legacy Posted Date
2016-01-18Usage metrics
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