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Determinants of outcome in elderly patients with positive sentinel lymph nodes
Amer K Karam1, Meier Hsu, Sujata Patil
1Breast Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, Evelyn H. Lauder Breast Center, New York, NY 10065, USA.
Background:
Older women are less likely to receive standard of care treatment for breast cancer.
Methods:
We examined variables that affected the outcome of elderly patients ≥70 years old among 1,470 patients with invasive cancer with positive sentinel lymph nodes (SLNs).
Results:
Elderly patients were less likely to undergo mastectomy, completion axillary node dissection (ALND), adjuvant chemotherapy, and radiotherapy (RT) following breast-conserving therapy (BCT) compared with patients <70 years old. The 5-year risk of disease progression and cumulative incidence of breast cancer-specific deaths were not significantly different for both groups. On multivariate analysis, hormone receptor-negative status, number of metastatic lymph nodes, high nuclear grade, and tumor size were the factors independently associated with increased risk of disease progression.
Conclusions:
Tumor factors were the primary determinants of breast cancer outcomes in our cohort. Elderly patients are less likely to receive aggressive surgical interventions and adjuvant therapy because of perceived life expectancy.
