PDF icon PDF herunterladen
Open Access
CC BY-NC-ND 4.0 · South Asian J Cancer 2018; 07(02): 123-126
DOI: 10.4103/sajc.sajc_117_18
Original Article

Practical consensus recommendations regarding the management of hormone receptor positive early breast cancer in elderly women

Govind Babu
Department of Medical Oncology, KMIO, Bengaluru, Karnataka
,
A. Goel
Department of Surgical Oncology, Max Hospital, New Delhi
,
S. Agarwal
Department of Radiation Oncology, Max Hospital, New Delhi
,
S. Gupta
Department of Medical Oncology, Sarvodaya Hospital, Faridabad, Haryana
,
P. Kumar
Department of Radiation Oncology, Ram Murti Medical College, Bareilly, Uttar Pradesh
,
B. K. Smruti
Department of Medical Oncology, Bombay Hospital, Mumbai, Maharashtra
,
V. Goel
Department of Radiation Oncology, Max Hospital, New Delhi
,
R. Sarangi
Department of Surgery, Sir Ganga Ram Hospital, New Delhi
,
M. Gairola
Department of Radiation Oncology, RGCI, New Delhi
,
S. Aggarwal
Department of Medical Oncology, Sir Ganga Ram Hospital, New Delhi
,
Purvish K. Parikh
Department of Oncology, Shalby Cancer and Research Institute, Mumbai, Maharashtra
› Institutsangaben
Financial support and sponsorship: Nil.
› Weitere Informationen
Auch verfügbar aufeRef
 als PDF herunterladen Lizenzen und Reprints
Preview

Abstract

Breast cancer is a leading cause of death among women, and its incidence increases with age. Currently the treatment of breast cancer in older patients is almost identical to their younger counterparts. This expert group used data from published literature, practical experience and opinion of a large group of academic oncologists to arrive at these practical consensus recommendations for the benefit of community oncologists regarding the management of early breast cancer specifically in elderly women.

Key words

Axillary node - biomarkers - breast conservation surgery - Ki67 - radiotherapy


Publikationsverlauf

Artikel online veröffentlicht:
22. Dezember 2020

© 2018. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 NCRP – Three Year Report of the Population Based Cancer Registries 2012 – 2014, National Cancer Registry Programme. Bangalore: Indian Council of Medical Research; 2016.
  • 2 NNCRP – Consolidated Report of the Hospital Based Cancer Registries 2012 – 2014, National Cancer Registry Programme. Bangalore: Indian Council of Medical Research; 2016.
  • 3 Kiderlen M, Bastiaannet E, Walsh PM, Keating NL, Schrodi S, Engel J, et al. Surgical treatment of early stage breast cancer in elderly: An international comparison. Breast Cancer Res Treat 2012;132:675-82.
  • 4 Robertson JF, Todd JH, Ellis IO, Elston CW, Blamey RW. Comparison of mastectomy with tamoxifen for treating elderly patients with operable breast cancer. BMJ 1988;297:511-4.
  • 5 Gazet JC, Ford HT, Coombes RC, Bland JM, Sutcliffe R, Quilliam J, et al. Prospective randomized trial of tamoxifen vs. surgery in elderly patients with breast cancer. Eur J Surg Oncol 1994;20:207-14.
  • 6 International Breast Cancer Study Group, Rudenstam CM, Zahrieh D, Forbes JF, Crivellari D, Holmberg SB, et al. Randomized trial comparing axillary clearance versus no axillary clearance in older patients with breast cancer:First results of International Breast Cancer Study Group Trial 10-93. J Clin Oncol 2006;24:337-44.
  • 7 Martelli G, Miceli R, Daidone MG, Vetrella G, Cerrotta AM, Piromalli D, et al. Axillary dissection versus no axillary dissection in elderly patients with breast cancer and no palpable axillary nodes: Results after 15 years of follow-up. Ann Surg Oncol 2011;18:125-33.
  • 8 Giuliano AE, Hunt KK, Ballman KV, Beitsch PD, Whitworth PW, Blumencranz PW, et al. Axillary dissection vs. no axillary dissection in women with invasive breast cancer and sentinel node metastasis: A randomized clinical trial. JAMA 2011;305:569-75.
  • 9 Fisher B, Anderson S, Bryant J, Margolese RG, Deutsch M, Fisher ER, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med 2002;347:1233-41.
  • 10 Fyles AW, McCready DR, Manchul LA, Trudeau ME, Merante P, Pintilie M, et al. Tamoxifen with or without breast irradiation in women 50 years of age or older with early breast cancer. N Engl J Med 2004;351:963-70.
  • 11 Hughes KS, Schnaper LA, Berry D, Cirrincione C, McCormick B, Shank B, et al. Lumpectomy plus tamoxifen with or without irradiation in women 70 years of age or older with early breast cancer. N Engl J Med 2004;351:971-7.
  • 12 Smith BD, Gross CP, Smith GL, Galusha DH, Bekelman JE, Haffty BG, et al. Effectiveness of radiation therapy for older women with early breast cancer. J Natl Cancer Inst 2006;98:681-90.
  • 13 Smith BD, Haffty BG, Hurria A, Galusha DH, Gross CP. Postmastectomy radiation and survival in older women with breast cancer. J Clin Oncol. 2006;24:4901–4907.
  • 14 Truong PT, Bernstein V, Lesperance M, Speers CH, Olivotto IA. Radiotherapy omission after breast-conserving surgery is associated with reduced breast cancer-specific survival in elderly women with breast cancer. Am J Surg 2006;191:749-55.
  • 15 Clarke M, Collins R, Darby S, Davies C, Elphinstone P, Evans V, et al. Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: An overview of the randomised trials. Lancet 2005;366:2087-106.
  • 16 Early Breast Cancer Trialists' Collaborative Group (EBCTCG), Darby S, McGale P, Correa C, Taylor C, Arriagada R, et al. Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: Meta-analysis of individual patient data for 10,801 women in 17 randomised trials. Lancet 2011;378:1707-16.
  • 17 Tamoxifen for early breast cancer: An overview of the randomised trials. Early Breast Cancer Trialists' Collaborative Group. Lancet 1998;351:1451-67.
  • 18 VanderWalde A, Hurria A. Early breast cancer in the older woman. Clin Geriatr Med 2012;28:73-91.
  • 19 Early Breast Cancer Trialists' Collaborative Group (EBCTCG). Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: An overview of the randomised trials. Lancet 2005;365:1687-717.
  • 20 Crivellari D, Price K, Gelber RD, Castiglione-Gertsch M, Rudenstam CM, Lindtner J, et al. Adjuvant endocrine therapy compared with no systemic therapy for elderly women with early breast cancer: 21-year results of International Breast Cancer Study Group Trial IV. J Clin Oncol 2003;21:4517-23.
  • 21 Polychemotherapy for early breast cancer: An overview of the randomised trials. Early Breast Cancer Trialists' Collaborative Group. Lancet 1998;352:930-42.
  • 22 Burdette-Radoux S, Muss HB. Adjuvant chemotherapy in the elderly: Whom to treat, what regimen? Oncologist 2006;11:234-42.
  • 23 Muss HB, Berry DA, Cirrincione CT, Theodoulou M, Mauer AM, Kornblith AB, et al. Adjuvant chemotherapy in older women with early-stage breast cancer. N Engl J Med 2009;360:2055-65.
  • 24 Giordano SH, Duan Z, Kuo YF, Hortobagyi GN, Goodwin JS. Use and outcomes of adjuvant chemotherapy in older women with breast cancer. J Clin Oncol 2006;24:2750-6.
  • 25 Elkin EB, Hurria A, Mitra N, Schrag D, Panageas KS. Adjuvant chemotherapy and survival in older women with hormone receptor-negative breast cancer: Assessing outcome in a population-based, observational cohort. J Clin Oncol 2006;24:2757-64.
  • 26 Berry DA, Cirrincione C, Henderson IC, Citron ML, Budman DR, Goldstein LJ, et al. Estrogen-receptor status and outcomes of modern chemotherapy for patients with node-positive breast cancer. JAMA 2006;295:1658-67.
  • 27 Mungle T, Tewary S, Arun I, Basak B, Agarwal S, Ahmed R, et al. Automated characterization and counting of Ki-67 protein for breast cancer prognosis: A quantitative immunohistochemistry approach. Comput Methods Programs Biomed 2017;139:149-61.
  • 28 Dowsett M, Nielsen TO, A'Hern R, Bartlett J, Coombes RC, Cuzick J, et al. Assessment of Ki67 in breast cancer: Recommendations from the international Ki67 in breast cancer working group. J Natl Cancer Inst 2011;103:1656-64.
  • 29 Bertucci F, Birnbaum D. Reasons for breast cancer heterogeneity. J Biol 2008;7:6.
  • 30 Polyak K. Heterogeneity in breast cancer. J Clin Invest 2011;121:3786-8.
  • 31 Yersal O, Barutca S. Biological subtypes of breast cancer: Prognostic and therapeutic implications. World J Clin Oncol 2014;5:412-24.
  • 32 Munkácsy G, Szász MA, Menyhárt O. Gene expression-based prognostic and predictive tools in breast cancer. Breast Cancer 2015;22:245-52.
  • 33 de Azambuja E, Cardoso F, de Castro G Jr., Colozza M, Mano MS, Durbecq V, et al. Ki-67 as prognostic marker in early breast cancer: A meta-analysis of published studies involving 12,155 patients. Br J Cancer 2007;96:1504-13.
  • 34 Sharma S, Hiran KR, Pavithran K, Vijaykumar DK. A pilot study to assess the feasibility of evaluation of markers of response to chemotherapy at one day and 21 days after first cycle of chemotherapy in carcinoma of breast: A prospective non-randomized observational study. World J Surg Oncol 2009;7:35.
  • 35 Bottini A, Berruti A, Bersiga A, Brizzi MP, Bruzzi P, Aguggini S, et al. Relationship between tumour shrinkage and reduction in Ki67 expression after primary chemotherapy in human breast cancer. Br J Cancer 2001;85:1106-12.
  • 36 Bottini A, Berruti A, Bersiga A, Brunelli A, Brizzi MP, Marco BD, et al. Effect of neoadjuvant chemotherapy on Ki67 labelling index, c-erbB-2 expression and steroid hormone receptor status in human breast tumours. Anticancer Res 1996;16:3105-10.
  • 37 Ellis PA, Smith IE, Detre S, Burton SA, Salter J, A'Hern R, et al. Reduced apoptosis and proliferation and increased Bcl-2 in residual breast cancer following preoperative chemotherapy. Breast Cancer Res Treat 1998;48:107-16.
  • 38 Clarke RB, Laidlaw IJ, Jones LJ, Howell A, Anderson E. Effect of tamoxifen on Ki67 labelling index in human breast tumours and its relationship to oestrogen and progesterone receptor status. Br J Cancer 1993;67:606-11.
  • 39 Dardes RD, Horiguchi J, Jordan VC. A pilot study of the effects of short-term tamoxifen therapy on Ki-67 labelling index in women with primary breast cancer. Int J Oncol 2000;16:25-30.
  • 40 Makris A, Powles TJ, Allred DC, Ashley S, Ormerod MG, Titley JC, et al. Changes in hormone receptors and proliferation markers in tamoxifen treated breast cancer patients and the relationship with response. Breast Cancer Res Treat 1998;48:11-20.
  • 41 Chang J, Powles TJ, Allred DC, Ashley SE, Clark GM, Makris A, et al. Biologic markers as predictors of clinical outcome from systemic therapy for primary operable breast cancer. J Clin Oncol 1999;17:3058-63.
  • 42 Nielsen TO, Parker JS, Leung S, Voduc D, Ebbert M, Vickery T, et al. A comparison of PAM50 intrinsic subtyping with immunohistochemistry and clinical prognostic factors in tamoxifen-treated estrogen receptor-positive breast cancer. Clin Cancer Res 2010;16:5222-32.
  • 43 Chia SK, Bramwell VH, Tu D, Shepherd LE, Jiang S, Vickery T, et al. A 50-gene intrinsic subtype classifier for prognosis and prediction of benefit from adjuvant tamoxifen. Clin Cancer Res 2012;18:4465-72.
  • 44 Martín M, Prat A, Rodríguez-Lescure A, Caballero R, Ebbert MT, Munárriz B, et al. PAM50 proliferation score as a predictor of weekly paclitaxel benefit in breast cancer. Breast Cancer Res Treat 2013;138:457-66.
  • 45 Cheang MC, Voduc KD, Tu D, Jiang S, Leung S, Chia SK, et al. Responsiveness of intrinsic subtypes to adjuvant anthracycline substitution in the NCIC.CTG MA.5 randomized trial. Clin Cancer Res 2012;18:2402-12.
  • 46 Jørgensen CL, Nielsen TO, Bjerre KD, Liu S, Wallden B, Balslev E, et al. PAM50 breast cancer intrinsic subtypes and effect of gemcitabine in advanced breast cancer patients. Acta Oncol 2014;53:776-87.