Clinically cN0 breast cancer in elderly: what surgery?

Area of Science:

• Oncology
• Geriatric Medicine
• Surgical Oncology

Background:

• Breast carcinoma is a leading cancer in women globally, with incidence rising with age.
• Elderly patients often present with advanced disease but may have a more favorable tumor biology.
• Current management strategies for breast cancer in the elderly remain a subject of debate.

Purpose of the Study:

• To evaluate the impact of axillary dissection on disease-free survival (DFS) and overall survival (OS) in patients over 65.
• To determine the rate of potentially avoidable axillary dissections in this demographic.
• To contribute evidence to the ongoing discussion regarding breast cancer management in older adults.

Main Methods:

• Retrospective study of 133 patients aged over 65 treated at a single Breast Unit from 2009-2013.
• Analysis focused on the rate of avoidable axillary treatment, DFS, and OS.
• Patients were assessed for palpable axillary lymph nodes and axillary involvement.

Main Results:

• 109 out of 133 patients had non-palpable axillary lymph nodes.
• The rate of axillary involvement in patients without palpable nodes was 11.8%.
• No axillary recurrences were observed, regardless of treatment, with similar DFS and OS between treated and untreated axillae.

Conclusions:

• Axillary dissection avoidance did not negatively affect DFS or OS in elderly breast cancer patients.
• Individualized, multidisciplinary care is essential for determining optimal breast cancer treatment in older adults.
• Further research is needed to refine treatment guidelines for this population.