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Breast conservation in elderly women for clinically negative axillary lymph nodes without axillary dissection
D E Wazer1, J K Erban, N J Robert
1Breast Health Center, New England Medical Center, Tufts University School of Medicine, Boston, Massachusetts 02111.
Background:
A prospective study was initiated to explore an approach of limited therapy in elderly patients with early clinical stage breast cancer.
Methods:
Between 1982 and 1989, 73 women with American Joint Committee on Cancer Stage I/II, clinically negative axillary lymph nodes aged 65 years or older (median age, 74 years) were enrolled in a treatment program consisting of tumor excision, breast and regional lymph node irradiation, and, in 66 patients, tamoxifen. Patients were assessed for disease outcome and complications.
Results:
At a median follow-up of 54 months, 8-year rates of local and regional lymph node control were 92.5% and 100%, respectively. Eight-year probabilities of disease free, overall, and breast cancer specific survival were 84%, 52.5%, and 93.8%, respectively. There was minimal morbidity associated with either regional irradiation or tamoxifen.
Conclusions:
An approach to early breast cancer in the elderly that seeks to limit the aggressiveness of local and systemic therapies appears to result in a satisfactory disease outcome with few complications.