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Open Access 12-02-2024 | Breast Cancer | Breast Oncology

A Prospective Study of Sentinel Node Biopsy Omission in Women Age ≥ 65 Years with ER+ Breast Cancer

Authors: Alice P. Chung, MD, Catherine M. Dang, MD, Scott R. Karlan, MD, Farin F. Amersi, MD, Edward M. Phillips, MD, Marissa K. Boyle, MD, Yujie Cui, MS, Armando E. Giuliano, MD

Published in: Annals of Surgical Oncology | Issue 5/2024

Abstract

Background

National guidelines recommend omitting SNB in older patients with favorable invasive breast cancer. However, there is a lack of prospective data specifically addressing this issue. This study evaluates recurrence and survival in estrogen receptor-positive/Her2− (ER+) breast cancer patients, aged ≥ 65 years who have breast-conserving surgery (BCS) without SNB.

Methods

This is a prospective, observational study at a single institution where 125 patients aged ≥ 65 years with clinical T1-2N0 ER+ invasive breast cancer undergoing BCS were enrolled. Patients were treated with BCS without SNB. Primary outcome measure was axillary recurrence. Secondary outcome measures include recurrence-free survival (RFS), disease-free survival (DFS), breast cancer-specific survival (BCSS), and overall survival (OS).

Results

From January 2016 to July 2022, 125 patients were enrolled with median follow-up of 36.7 months [95% confidence interval (CI) 35.0–38.0]. Median age was 77.0 years (range 65–93). Median tumor size was 1 cm (range 0.1–5.0). Most tumors were ductal (95/124, 77.0%), intermediate grade (60/116, 51.7%), and PR-positive (117/123, 91.7%). Radiation therapy was performed in 37 of 125 (29.6%). Only 60 of 125 (48.0%) who were recommended hormonal therapy were compliant at 2 years. Chemotherapy was administered to six of 125 (4.8%) patients. There were two of 125 (1.6%) axillary recurrences. Estimated 3-years rates of regional RFS, DFS, and OS were 98.2%, 91.2%, and 94.8%, respectively. Univariate Cox regression identified hormonal therapy noncompliance to be significantly associated with recurrence (p = 0.02).

Conclusions

Axillary recurrence rates were extremely low in this cohort. These results provide prospective data to support omission of SNB in this patient population

Trial Registration

ClinicalTrials.gov ID NCT02564848.

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Title: A Prospective Study of Sentinel Node Biopsy Omission in Women Age ≥ 65 Years with ER+ Breast Cancer
Authors: Alice P. Chung, MD
Catherine M. Dang, MD
Scott R. Karlan, MD
Farin F. Amersi, MD
Edward M. Phillips, MD
Marissa K. Boyle, MD
Yujie Cui, MS
Armando E. Giuliano, MD
Publication date: 12-02-2024
Publisher: Springer International Publishing
Keywords: Breast Cancer
Breast Cancer
Estrogens
Published in: Annals of Surgical Oncology / Issue 5/2024
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-024-15000-w

Keynote webinar | Spotlight on medication adherence

Springer Medicine

A Prospective Study of Sentinel Node Biopsy Omission in Women Age ≥ 65 Years with ER+ Breast Cancer

Abstract

Background

Methods

Results

Conclusions

Trial Registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Trial Registration

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