Researchers from the M.D. Anderson Cancer Center suggest that treatment consisting of a segmental mastectomy plus post-operative radiation with or without lymph node dissection should be considered the standard of care for elderly patients with breast cancer, as recently reported in the journal Cancer.

Breast cancer is a common malignancy in the United States, with approximately 200,000 cases diagnosed annually. Nearly half of these diagnoses are in elderly women over the age of 65. Although many clinical trials have been conducted for the treatment of breast cancer, the elderly are often excluded due to perceived intolerability of treatment or concurrent medical conditions. Therefore, inadequate data exists for the appropriate designation of a standard treatment regimen for elderly patients with this disease.

Researchers from the M.D. Anderson Cancer Center recently analyzed the outcomes data from 184 elderly patients who were treated there between 1970 and 1994. These patients were diagnosed with stage 0 through stage III breast cancer and their treatment consisted of a segmental mastectomy followed by post-operative radiation. A segmental mastectomy involves the removal of the cancer plus a portion of the tissue surrounding the cancer. An axillary (under the arm) lymph node dissection was performed in 73% of patients, with 22% of these patients having cancer spread to the axillary lymph nodes. Adjuvant (post-operative) chemotherapy was given to 5% of patients and tamoxifen was given to 63 patients. Complications from treatment were reported in 13% of patients. Approximately 7 years following treatment, 5% of patients had a local recurrence, 5% developed cancer in the opposite breast and 11% developed distant spread of cancer. At 5 and 10 years following treatment, 96% and 91% of patients, respectively, had not died from their cancer.

The long-term outcomes and tolerability of therapy reported from this study prompted these researchers to suggest that treatment with segmental mastectomy followed by radiation should become the standard of care for elderly women with breast cancer without other significant medical complications. Elderly patients diagnosed with breast cancer should speak with their physician about the risks and benefits of this treatment regimen or about participation in clinical trials further evaluating treatment combinations. Two sources of ongoing information regarding clinical trials include comprehensive, easy-to-use listing services provided by the National Cancer Institute (cancer.gov) and eCancerTrials.com. eCancerTrials.com also provides personalized clinical trial searches on behalf of patients. (Cancer, Vol 92, No 5, pp 1092-1100, 2001)

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