Primary Endocrine Therapy in Older Women with Breast Cancer

被引：13

作者：

Pepping R.M.C. ^{[1
]}

Portielje J.E.A. ^{[1
,2
]}

van de Water W. ^{[3
]}

de Glas N.A. ^{[2
]}

机构：

[1] Department of Internal Medicine, Haga Hospital, The Hague

[2] Department of Clinical Oncology, Leiden University Medical Centre, P.O. Box 9600, Leiden

[3] Department of Surgery, Leiden University Medical Centre, Leiden

来源：

Current Geriatrics Reports | 2017年 / 6卷 / 4期

关键词：

Breast cancer; Elderly; Geriatric assessment; Geriatric oncology; Primary endocrine therapy; Surgery;

D O I：

10.1007/s13670-017-0223-z

中图分类号：

学科分类号：

摘要：

Purpose of Review: Breast cancer incidence increases with age. In recent years, primary endocrine therapy has been increasingly used as a treatment option for frail elderly women with breast cancer, although surgery is still the guideline-recommended treatment. In this review, we discuss the evidence for primary endocrine therapy versus surgical treatment in older women with early breast cancer. Recent Findings: Both randomised controlled trials and recent observational studies showed a favourable progression-free survival but not overall survival for surgery plus adjuvant endocrine therapy versus primary endocrine therapy. Information about quality of life with either treatment strategy is so far lacking. Deciding who is fit for surgery and has sufficiently long life expectation to be at risk of disease progression can be supported by performing an individual geriatric assessment. Summary: This review suggests that primary endocrine therapy is a reasonable alternative to primary surgery in frail older women with breast cancer. Future studies should focus on the long-term effects on quality of life and physical functioning. © 2017, The Author(s).

引用

页码：239 / 246

页数：7

共 43 条

[1]

DeSantis C.M.J., Bryan L., Jemal A., Breast cancer statistics 2013, CA Cancer J Clin, 64, 1, pp. 52-62, (2014)

[2]

Kiderlen M., de Glas N.A., Bastiaannet E., van de Water W., de Craen A.J., Guicherit O.R., Et al., Impact of comorbidity on outcome of older breast cancer patients: a FOCUS cohort study, Breast Cancer Res Treat, 145, 1, pp. 185-192, (2014)

[3]

Performing survival analyses in the presence of competing risks: a clinical example in older breast cancer patients, J Natl Cancer Inst, (2016)

[4]

Gaskell D.J., Hawkins R.A., De Carteret S., Chetty U., Sangster K., Forrest A.P.M., Indications for primary tamoxifen therapy in elderly women with breast cancer, Br J Surg, 79, 12, pp. 1317-1320, (1992)

[5]

Engels C.C., Kiderlen M., Bastiaannet E., Mooyaart A.L., van Vlierberghe R., Smit V.T., Kuppen P.J., van de Velde C.J., Liefers G.J., The clinical prognostic value of molecular intrinsic tumor subtypes in older breast cancer patients: a FOCUS study analysis, Mol Oncol, 10, 4, pp. 594-600, (2016)

[6]

Cheung K.L., Wong A.W., Parker H., Li V.W., Winterbottom L., Morgan D.A., Et al., Pathological features of primary breast cancer in the elderly based on needle core biopsies—a large series from a single centre, Crit Rev Oncol Hematol, 67, 3, pp. 263-267, (2008)

[7]

Biganzoli L.W.H., Oakman C., Marotti L., Loibl S., Kunkler I., Et al., Management of elderly patients with breast cancer: updated recommendations of the International Society of Geriatric Oncology (SIOG) and European Society of Breast Cancer Specialists (EUSOMA), The Lancet Oncology, 13, 4, pp. 148-160, (2012)

[8]

Wildiers H.K.I., Biganzoli L., Fracheboud J., Vlastos G., Bernard-Marty C., Et al., Management of breast cancer in elderly individuals: recommendations of the International Society of Geriatric Oncology, The Lancet Oncology, 8, 12, pp. 1101-1115, (2007)

[9]

Zulman D.M.S.J., Chen X., Cigolle C.T., Blaum C.S., Ra H., Examining the evidence: a systematic review of the inclusion and analysis of older adults in randomized controlled trials, J Gen Intern Med, 26, 7, pp. 783-790, (2011)

[10]

van de Water W.K.M., Bastiaannet E., Siesling S., Westendorp R.G., van de Velde C.J., Et al., External validity of a trial comprised of elderly patients with hormone receptor-positive breast cancer, J Natl Cancer Inst, 106, 4, (2014)

← 1 2 3 4 5 →