Are we choosing wisely in elderly females with breast cancer?

被引:17
作者
Calderon, Esteban [1 ]
Webb, Christopher [1 ]
Kosiorek, Heidi E. [2 ]
Gray, M. D. Richard J. [1 ]
Cronin, Patricia [1 ]
Anderson, Karen [3 ]
Northfelt, Donald [3 ]
McCullough, Ann [4 ]
Ocal, Idris Tolgay [4 ]
Pockaj, Barbara [1 ]
机构
[1] Mayo Clin Arizona, Dept Surg, Div Surg Oncol, Scottsdale, AZ USA
[2] Mayo Clin Arizona, Dept Res Biostat, Scottsdale, AZ USA
[3] Mayo Clin Arizona, Dept Med, Div Hematol Oncol, Scottsdale, AZ USA
[4] Mayo Clin Arizona, Dept Lab Med & Pathol, Scottsdale, AZ USA
关键词
Breast cancer; Radiation therapy; Sentinel lymph node; Mammography; Elderly; LUMPECTOMY PLUS TAMOXIFEN; NO AXILLARY DISSECTION; OLDER WOMEN; CONSERVING SURGERY; MAMMOGRAPHY; STAGE; AGE; IRRADIATION; TRIAL; RADIOTHERAPY;
D O I
10.1016/j.amjsurg.2019.08.004
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background: The Choosing Wisely Organization and the American College of Surgeons have issued recommendations for patients >70 with breast cancer involving screening and use of radiation therapy (RT) and sentinel lymph node biopsies (SNLB) in early stage tumors. This study evaluated compliance and implementation of these recommendations. Methods: A database of patients undergoing breast cancer surgery was retrospectively queried from 2002 to 2017. Patients were divided into cohorts before and after the year of each guideline publication. Results: The rate of presentation on mammography was not different before 2009 (65%) vs. after 2009 (66%). RT was given to 57% of patients with T1 ER + Her2-prior to 2013 vs. 27% after (p=<0.001). SLNB was performed in 91% of patients with T1, grade1/2, ER + Her2-tumors prior to 2016 vs. 56% after (p=<0.001). Conclusion: Rates of mammography detected breast cancer have not decreased but adjuvant RT and SLNB are less frequently performed in low risk breast cancer in the elderly. (C) 2019 Elsevier Inc. All rights reserved.
引用
收藏
页码:1229 / 1233
页数:5
相关论文
共 34 条
[1]  
[Anonymous], 2016, REC OM RAD THER LUMP
[2]   Mammography before diagnosis among women age 80 years and older with breast cancer [J].
Badgwell, Brian D. ;
Giordano, Sharon H. ;
Duan, Zhigang Z. ;
Fang, Shenying ;
Bedrosian, Isabelle ;
Kuerer, Henry M. ;
Singletary, S. Eva ;
Hunt, Kelly K. ;
Hortobagyi, Gabriel N. ;
Babiera, Gildy .
JOURNAL OF CLINICAL ONCOLOGY, 2008, 26 (15) :2482-2488
[3]   ASBRS Great Debate: Sentinel Node Biopsy in Patients Over 70 Years of Age [J].
Blair, Sarah L. ;
Tsai, Catherine ;
Tafra, Lorraine .
ANNALS OF SURGICAL ONCOLOGY, 2018, 25 (10) :2813-2817
[4]   Screening Outcomes in Older US Women Undergoing Multiple Mammograms in Community Practice: Does Interval, Age, or Comorbidity Score Affect Tumor Characteristics or False Positive Rates? [J].
Braithwaite, Dejana ;
Zhu, Weiwei ;
Hubbard, Rebecca A. ;
O'Meara, Ellen S. ;
Miglioretti, Diana L. ;
Geller, Berta ;
Dittus, Kim ;
Moore, Dan ;
Wernli, Karen J. ;
Mandelblatt, Jeanne ;
Kerlikowske, Karla .
JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE, 2013, 105 (05) :334-341
[5]   Tamoxifen with radiotherapy compared with Tamoxifen alone in elderly women with early-stage breast cancer treated with breast conserving surgery: A systematic review and meta-analysis [J].
Chesney, Tyler R. ;
Yin, Jennifer Xin ;
Rajaee, Nikoo ;
Tricco, Andrea C. ;
Fyles, Anthony W. ;
Acuna, Sergio A. ;
Scheer, Adena S. .
RADIOTHERAPY AND ONCOLOGY, 2017, 123 (01) :1-9
[6]   Impact of CALGB 9343 Trial and Sociodemographic Variation on Patterns of Adjuvant Radiation Therapy Practice for Elderly Women (≥70 Years) with Stage I, Estrogen Receptor-positive Breast Cancer: Analysis of the National Cancer Data Base [J].
Chu, Quyen D. ;
Zhou, Meijiao ;
Medeiros, Kaelen L. ;
Peddi, Prakash ;
Wu, Xiao Cheng .
ANTICANCER RESEARCH, 2017, 37 (10) :5585-5594
[7]   Utilization of screening mammography in older women according to comorbidity and age: Protocol for a systematic review [J].
Demb J. ;
Allen I. ;
Braithwaite D. .
Systematic Reviews, 5 (1)
[8]   Radiation Therapy After Breast-Conserving Surgery in Women 70 Years of Age and Older: How Wisely Do We Choose? [J].
Downs-Canner, Stephanie ;
Zabor, Emily C. ;
Wind, Tyler ;
Cobovic, Armend ;
McCormick, Beryl ;
Morrow, Monica ;
Heerdt, Alexandra .
ANNALS OF SURGICAL ONCOLOGY, 2019, 26 (04) :969-975
[9]   Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10 801 women in 17 randomised trials [J].
Darby S. ;
McGale P. ;
Correa C. ;
Taylor C. ;
Arriagada R. ;
Clarke M. ;
Cutter D. ;
Davies C. ;
Ewertz M. ;
Godwin J. ;
Gray R. ;
Pierce L. ;
Whelan T. ;
Wang Y. ;
Peto R. ;
Albain K. ;
Anderson S. ;
Barlow W. ;
Bergh J. ;
Bliss J. ;
Buyse M. ;
Cameron D. ;
Carrasco E. ;
Coates A. ;
Collins R. ;
Costantino J. ;
Cuzick J. ;
Davidson N. ;
Davies K. ;
Delmestri A. ;
Di Leo A. ;
Dowsett M. ;
Elphinstone P. ;
Evans V. ;
Gelber R. ;
Gettins L. ;
Geyer C. ;
Goldhirsch A. ;
Gregory C. ;
Hayes D. ;
Hill C. ;
Ingle J. ;
Jakesz R. ;
James S. ;
Kaufmann M. ;
Kerr A. ;
MacKinnon E. ;
McHugh T. ;
Norton L. ;
Ohashi Y. .
LANCET, 2011, 378 (9804) :1707-1716
[10]   Screening for breast cancer with mammography [J].
Gotzsche, Peter C. ;
Nielsen, Margrethe .
COCHRANE DATABASE OF SYSTEMATIC REVIEWS, 2011, (01)