Clinical outcome of primary endocrine therapy for Chinese patients aged 70 years or older with operable breast cancer

Abstract

Background: This study aims to evaluate the clinical outcome of primary endocrine therapy for elderly Chinese patients with operable breast cancer. Methods: We performed a retrospective review of elderly patients (age ≥70 years) with operable breast cancer who received primary endocrine therapy in a university hospital from January 2000 to December 2009. Results: During the study period, 39 Chinese patients (median age at diagnosis: 85 years; interquartile range [IQR]: 77–99 years) having operable breast cancer received primary endocrine therapy with a mean follow-up of 58 months. Nineteen patients (49%) had an initial response (median time to response [TTR]: 5 months; IQR: 4–17), while 17 patients (44%) showed stable disease. A total of 21 patients (54%), with or without prior response, eventually displayed progression (median time to progression [TTP]: 19 months; IQR: 11–52). Eight patients (21%) required salvage or palliative therapy. No significant difference in TTR and TTP was observed between the patients starting with tamoxifen and those starting with an aromatase inhibitor. Median overall survival for early stage (stage 0–2) was 58 months (IQR: 35–66) and for late stage (stage 3) was 72 months (IQR: 37–91; p = 0.351). Twenty-six patients (67%) died within the censor period. Ten of them (39%) died of breast cancer. Discussion: Primary endocrine therapy was a reasonable option for elderly patient with operable breast cancer. Majority of patient can achieve stable disease, partial response or even complete clinical response. They have fairly good overall survival and majority of them are died of cause other than breast cancer.