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Omission of adjuvant radiotherapy in low-risk elderly males with breast cancer

Vo, Kim ; Ladbury, Colton ; Yoon, Stephanie ; Bazan, Jose ; Glaser, Scott ; Amini, Arya

Breast cancer (Tokyo, Japan), 2024-05, Vol.31 (3), p.485-495 [Periódico revisado por pares]

Singapore: Springer Nature Singapore

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Título:
Omission of adjuvant radiotherapy in low-risk elderly males with breast cancer
Autor: Vo, Kim ; Ladbury, Colton ; Yoon, Stephanie ; Bazan, Jose ; Glaser, Scott ; Amini, Arya
Assuntos: Aged ; Aged, 80 and over ; Antineoplastic Agents, Hormonal - therapeutic use ; Breast Neoplasms, Male - mortality ; Breast Neoplasms, Male - pathology ; Breast Neoplasms, Male - radiotherapy ; Breast Neoplasms, Male - therapy ; Cancer Research ; Databases, Factual ; Female ; Humans ; Kaplan-Meier Estimate ; Male ; Mastectomy, Segmental ; Medicine ; Medicine & Public Health ; Oncology ; Original Article ; Radiotherapy, Adjuvant - methods ; Retrospective Studies ; Surgery ; Surgical Oncology ; Survival Rate
É parte de: Breast cancer (Tokyo, Japan), 2024-05, Vol.31 (3), p.485-495
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
Descrição: Purpose Randomized clinical trials demonstrate that lumpectomy + hormone therapy (HT) without radiation therapy (RT) yields equivalent survival and acceptable local–regional outcomes in elderly women with early-stage, node-negative, hormone-receptor positive (HR +) breast cancer. Whether these data apply to men with the same inclusion criteria remains unknown. Methods The National Cancer Database was queried for male patients ≥ 65 years with pathologic T1-2N0 (≤ 3 cm) HR + breast cancer treated with breast-conserving surgery with negative margins from 2004 to 2019. Adjuvant treatment was classified as HT alone, RT alone, or HT + RT. Male patients were matched with female patients for OS comparison. Survival analysis was performed using Cox regression and Kaplan − Meier method. Inverse probability of treatment weighting (IPTW) was applied to adjust for confounding. Results A total of 523 patients met the inclusion criteria, with 24.4% receiving HT, 16.3% receiving RT, and 59.2% receiving HT + RT. The median follow-up was 6.9 years (IQR: 5.0–9.4 years). IPTW-adjusted 5-yr OS rates in the HT, RT, and HT + RT cohorts were 84.0% (95% CI 77.1–91.5%), 81.1% (95% CI 71.1–92.5%), and 93.0% (95% CI 90.0–96.2%), respectively. On IPTW-adjusted MVA, relative to HT, receipt of HT + RT was associated with improvements in OS (HR: 0.641; p = 0.042). RT alone was not associated with improved OS (HR: 1.264; p = 0.420). Conclusion Among men ≥ 65 years old with T1-2N0 HR + breast cancer, RT alone did not confer an OS benefit over HT alone. Combination of RT + HT demonstrated significant improvements in OS. De-escalation of treatment through omission of either RT or HT at this point should be done with caution.
Editor: Singapore: Springer Nature Singapore
Idioma: Inglês

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Omission of adjuvant radiotherapy in low-risk elderly males with breast cancer

Vo, Kim ; Ladbury, Colton ; Yoon, Stephanie ; Bazan, Jose ; Glaser, Scott ; Amini, Arya

Singapore: Springer Nature Singapore

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