Morgan, J.L., Reed, M.W. and Wyld, L. orcid.org/0000-0002-4046-5940 (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 (EJSO), 40 (6). pp. 676-684. ISSN 0748-7983
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.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2014 Elsevier Ltd. This is the pre-peer review, submitted version of the paper, which was subsequently published in European Journal of Surgical Oncology after amendments. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | Breast cancer; primary endocrine therapy; surgery; elderly; systematic review |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > The Medical School (Sheffield) |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 11 Jan 2021 10:55 |
Last Modified: | 11 Jan 2021 14:04 |
Status: | Published |
Publisher: | Elsevier |
Refereed: | No |
Identification Number: | 10.1016/j.ejso.2014.02.224 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:169876 |