Thomas, R;
Rowell, R;
Crichton, S;
Cain, H;
(2018)
Patients electing to have PET rather than surgery for operable breast cancer are a high risk of treatment failure.
Breast Cancer Research and Treatment
, 172
(3)
pp. 597-601.
10.1007/s10549-018-4943-3.
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Abstract
Background: Primary endocrine therapy (PET) is a treatment option for elderly patients with ER-positive breast cancer enabling frail patients to avoid surgery. As a long-term treatment option, it has been shown to be inferior to surgery in controlling local disease. Decision-making in these patients is crucial in avoiding treatment failure. We examined the influence of decision-making on outcomes of PET failure as a secondary analysis as part of a large observational study. Methods: Consecutive patients treated with PET between 2005 and 2015 for operable breast cancers were included in a retrospective observational study in 3 breast centres in the North-East. Treatment decision processes were examined by case note review and outcomes of treatment success or failure recorded. Results: 488 patients were included with mean follow-up of 31 months. Overall 63 (12%) experienced treatment failure. 227 (46.6%) were given a choice between surgery and PET at diagnosis. Logistic regression identified older age [OR 0.94 (0.91–0.96) p < 0.001] and reduced mobility [OR 0.6 (0.37–0.97) p 0.036] to be less likely offered surgery. Those offered surgery were more likely to experience treatment failure with PET [SHR 1.78 (1.05–3.02) p 0.033]. Conclusions: Despite a low failure rate in our series (literature failure rates vary between 12 and 85%), these results suggest that those actively offered a choice between surgery and PET are at greater risk of failure when choosing PET.
| Type: | Article |
|---|---|
| Title: | Patients electing to have PET rather than surgery for operable breast cancer are a high risk of treatment failure |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1007/s10549-018-4943-3 |
| Publisher version: | http://doi.org/10.1007/s10549-018-4943-3 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Primary endocrine therapy; breast cancer; elderly |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology > MRC Clinical Trials Unit at UCL |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10067974 |
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