Determinants of outcome in elderly patients with positive sentinel lymph nodes |
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| Authors: | Amer K Karam MD Meier Hsu MS Sujata Patil PhD Michelle Stempel MS Tiffany A Traina MD Alice Y Ho MD Hiram S Cody MD Monica Morrow MD Mary L Gemignani MD MPH |
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| Institution: | aBreast Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, Evelyn H. Lauder Breast Center, 300 E. 66th St, New York, NY 10065, USA;bDepartment of Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA;cDepartment of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA;dDepartment of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA |
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| Abstract: | BackgroundOlder women are less likely to receive standard of care treatment for breast cancer.MethodsWe examined variables that affected the outcome of elderly patients ≥70 years old among 1,470 patients with invasive cancer with positive sentinel lymph nodes (SLNs).ResultsElderly patients were less likely to undergo mastectomy, completion axillary node dissection (ALND), adjuvant chemotherapy, and radiotherapy (RT) following breast-conserving therapy (BCT) compared with patients <70 years old. The 5-year risk of disease progression and cumulative incidence of breast cancer–specific deaths were not significantly different for both groups. On multivariate analysis, hormone receptor–negative status, number of metastatic lymph nodes, high nuclear grade, and tumor size were the factors independently associated with increased risk of disease progression.ConclusionsTumor factors were the primary determinants of breast cancer outcomes in our cohort. Elderly patients are less likely to receive aggressive surgical interventions and adjuvant therapy because of perceived life expectancy. |
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| Keywords: | Elderly patients Sentinel lymph nodes Lymph nodes Outcomes |
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