Sized Influences Nodal Status in Women Aged #70 with Endocrine Responsive Breast Cancer

Excerpt

Nodal stage still impacts on the indication for systemic chemotherapy, extended adjuvant endocrine therapy as well as locoregional radiotherapy. Thus, we read with great interest the article by Boughey et al. published online 2017 in Ann Surg Oncol entitled “Has the Time Come to Stop Surgical Staging of the Axilla for All Women Age 70 Years or Older with Hormone Receptor-Positive Breast Cancer?”1 The authors analyzed data from the National Cancer Database and the Mayo Clinic Rochester and demonstrated that only 15% of women 70 years or older with endocrine responsive breast cancer (≥ 70/Er +) had positive lymph node involvement (at least pN1). Tumor size expectedly correlated with the risk of lymph node involvement. The authors concluded that based on tumor size and grading there may be a subgroup of patients ≥ 70/Er + who may omit axillary staging as it may neither improve overall nor disease free survival. More over the society of surgical oncology (SSO) has recently recommended that “do not routinely perform SLN surgery for women older than 70 years with hormone receptor-positive breast cancer. http://​www.​surgonc.​org/​newspublications​/​for-the-press/​2016/​07/​12/​the-society-of-surgicaloncology​-encourages-doctors-patients-to-question-specific-commonlyused-tests-and-treatments-as-part-of-choosing-wisely-campaign” …