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Emens, M.D., Ph.D., George Tseng, Ph.D., and Oscar C.

Shapiro, M.D., Robert Ferris, M.D., Ph.D., Leisha A. Brufsky, M.D., Ph.D., Steffi Oesterreich, Ph.D., Steve D. вЂњThis is the result of an incredible collaborative of researchers, oncologists and clinical analytics experts.вЂќДЄdditional authors on the study are Jian Zou, Yusi Fang, Steve Koscumb, Osama Shah, Fangyuan Chen, Sushil Beriwal, M.D., Emilia J. вЂњOur study is unique in that we were able to look at very granular patient data, thanks to the size of our health system and the availability of electronic medical records, which makes the findings more robust than any other such study to date,вЂќ said Neil Carleton, lead author and an M.D./Ph.D.

Most importantly, they found that the rates of disease recurrence or survival remained the same, whether the carefully selected patients received SLNB or RT, or not-no matter their comorbidities or tumor grade. The rates of SLNB also steadily increased by 1% per year, while rates of RT declined by 3.4% per year over the study period. The researchers found that the number of SLNB and RT procedures among patients over age 70 remained high at 65.3% and 54.4% respectively.

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Side effects including nerve pain, lymphedema and skin irritation can sometimes occur after these procedures, which may be more difficult for the older patient to overcome. The study looked at two procedures: sentinel lymph node biopsy (SLNB), which is a surgical procedure to remove the lymph nodes from the underarm to determine if the cancer has spread beyond the breast, and radiotherapy (RT), which is standard treatment after breast-conserving surgery, given in multiple doses to control or kill any residual tumor. The data, collected at 15 UPMC Hillman Cancer Center community and academic sites, were evaluated with the UPMC Network Cancer Registry, which tracks cancer patients using UPMCвЂ™s electronic health record system. Age 70 was used because clinical trials in breast cancer donвЂ™t often include women in this age category. To determine whether patients were being overtreated, the researchers analyzed deidentified data from more than 3,000 women over the age of 70 who were diagnosed with ER-positive, HER2-negative breast cancer from 2010 to 2018. вЂњHowever, we have found that overtreatment of early-stage breast cancer in older patients may actually cause harm while not improving recurrence or survival rates.вЂќДespite guidelines recommending the de-escalation of treatment among older women with early-stage cancer, there has been no definitive study of this patient cohort, who often are excluded in clinical trials because of their age. вЂњAs a breast surgeon, I want to give my patients the best chance of survival with the best quality of life,вЂќ said senior author Priscilla McAuliffe, M.D., Ph.D., surgical oncologist at UPMC Hillman Cancer Center and attending surgeon in the Department of Surgery at Pitt. untreated elderly patients diagnosed in the early stages of the cancer diagnosed most commonly in women. A study published today in JAMA Network Open by researchers at UPMC Hillman Cancer Center and the University of Pittsburgh School of Medicine sheds new light on this choice and suggests the rate of cancer recurrence or survival may be no different in treated vs. Pittsburgh вЂ“Oncologists faced with treating older women with breast cancer often must decide if the treatment may be more detrimental than the cancer.

Services for Cancer Patients & Families.Cancer Prevention and Early Detection Services.Office of Health Equity, Education, and Advocacy.For High School Students and Undergraduates.Cancer Immunology and Immunotherapy Program.Cancer Epidemiology and Prevention Program.UPMC Hillman Cancer Center scientists are committed to bringing innovative cancer discoveries from the lab to patients.

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