Single institution experience of sentinel lymph node biopsy in elderly patients

Abstract

negative breast cancer patients over 65 years old between January 2006 and January 2012 from our institution’s (an academic tertiary referral center) breast cancer tumor board (TB). From the TB database and further analysis of patients’ medical files, we recorded variables including TB proposal (adjuvant chemotherapy or surveillance), age, comorbidities, tumor stage, tumor grade, Balducci’s score as proposed by a comprehensive geriatric assessment (CGA), treatment characteristics and follow-up. Overall survival and progression-free survivalwere estimated using the Kaplan-Meier method Results: Overall, 51 triple-negative breast cancer patients files were identified. The median TNBC population age was 74.5 years, (range 66-94). Neo-adjuvant or adjuvant chemotherapy was advised by TB in 41/51 (80%) of patients, of whom 37 (72%) actually received the treatment. Eight and 29 patients received neo-adjuvant and adjuvant chemotherapy, respectively. The main reasons to not advise chemotherapy in TB were age and comorbidities. Of the 37 patients given adjuvant chemotherapy, 13 (38%) received anthracycline-based chemotherapy, 8 (22%) were treated by taxanes + anthracycline-based chemotherapy and 6 (16%) received taxane-based (other than anthracyclines) chemotherapy. Other protocols were found in 4 (11%) of patients, and missing data accounted for 5 (13%). Moreover, 25 patients (49%) underwent a CGA, ofwhomnoBalducci’s class 3 received chemotherapy according to the geriatrician’s recommendations. The median progression-free and overall survival were not reached at a median follow-up of 29 months. There was no difference in overall survival between patients assigned to chemotherapy or surveillance only (p= 0,3984), but we found a trend towards a better progressionfree survival (p = 0.08) for patients receiving adjuvant therapy Conclusion: Our results suggest that adjuvant chemotherapy is feasible in elderly women with early-stage triple-negative breast cancer. We found a trend towards a better progression-free survival, although no difference in overall survival. Larger studies of adjuvant chemotherapy in elderly breast cancer are mandatory, especially in patients with triple-negative disease