Skip to main content

Research Repository

Advanced Search

Management and outcomes for older women with early breast cancer treated with primary endocrine therapy (PET)

Hubbard, Thomas; Wright, Georgia; Morgan, Jenna; Martin, Charlene; Walters, Stephen; Cheung, Kwok-Leung; Audisio, Riccardo; Reed, Malcolm; Wyld, Lynda

Management and outcomes for older women with early breast cancer treated with primary endocrine therapy (PET) Thumbnail


Authors

Thomas Hubbard

Georgia Wright

Jenna Morgan

Charlene Martin

Stephen Walters

Riccardo Audisio

Malcolm Reed

Lynda Wyld



Abstract

Background: This study reports the detailed management and outcomes of women treated with Primary Endocrine Therapy (PET) in a large prospective UK cohort of older women (≥70) with breast cancer. Methods: This was an unplanned secondary analysis of a prospective, multicentre, observational study (The Age Gap study). Data were collected at baseline and regular intervals on patient, tumour and treatment characteristics with tumour RECIST response category recorded. Direct study follow-up was 24 months with longer-term survival data obtained from the UK cancer registry. Results: The Age Gap study recruited 3316 women across 56 breast units. Primary endocrine therapy (PET) was initiated for 505/3316 (15 %) women; median age was 84 (IQR 79–88) with median follow-up 41.9 months (IQR 27–60). Death occurred in 205/505(40.6 %) patients, 160/205; 78 % non- Breast Cancer related, 45/205; 21.9 % Breast Cancer related. Multivariate analysis identified older age (HR-1.055(95 % Confidence Interval: 1.029–1.084); P < 0.001) and higher Charlson Index (HR-1.166 (1.086–1.252); P < 0.001) as risk factors for all-cause mortality, but conversion to surgery (HR-0.372(0.152–0.914); P = 0.031) was protective. Grade 3 cancer (G1 vs G3 HR-0.28 (0.094–0.829); P = 0.022 & G2 vs G3 HR-0.469 (0.226–0.973); P = 0.042), axillary positivity (axilla positivity HR-2.548 (1.321–4.816); P = 0.005) and change of endocrine therapy (HR-3.010 (1.532–5.913); P = 0.001) were associated with worse breast cancer specific survival (BCSS). RECIST category was not significantly associated with either overall survival or BCSS (P > 0.05). Conclusion: Early disease response and change of endocrine therapy are not significantly associated with overall survival, conversion to surgery is linked to improved outcome. Prognosis is largely determined by age and comorbidity in older women treated with PET.

Citation

Hubbard, T., Wright, G., Morgan, J., Martin, C., Walters, S., Cheung, K.-L., Audisio, R., Reed, M., & Wyld, L. (2024). Management and outcomes for older women with early breast cancer treated with primary endocrine therapy (PET). Breast, 77, Article 103768. https://doi.org/10.1016/j.breast.2024.103768

Journal Article Type Article
Acceptance Date Jul 7, 2024
Online Publication Date Jul 7, 2024
Publication Date 2024-10
Deposit Date Jul 25, 2024
Publicly Available Date Jul 25, 2024
Journal Breast
Print ISSN 0960-9776
Electronic ISSN 1532-3080
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 77
Article Number 103768
DOI https://doi.org/10.1016/j.breast.2024.103768
Keywords Breast neoplasms, Endocrine therapy, Older adult
Public URL https://nottingham-repository.worktribe.com/output/37599494
Publisher URL https://www.thebreastonline.com/article/S0960-9776(24)00099-7/fulltext
Additional Information This article is maintained by: Elsevier; Article Title: Management and outcomes for older women with early breast cancer treated with primary endocrine therapy (PET); Journal Title: The Breast; CrossRef DOI link to publisher maintained version: https://doi.org/10.1016/j.breast.2024.103768; Content Type: article; Copyright: © 2024 The Authors. Published by Elsevier Ltd.

Files





You might also like



Downloadable Citations