Breast-conserving procedures preferred in older patients with breast cancer

Quality of life (QOL) is better among older breast cancer patients who undergo breast-conserving procedures rather than mastectomy, results of a study published in the May issue of the European Journal of Cancer suggest.

“Mastectomy and breast-conserving treatment have proven equally effective in terms of survival in early breast cancer, but studies continue to provide evidence that patients undergoing breast-conserving procedures have a better QOL,” Dr. J. C. J. M de Haes, of Academic Medical Hospital, Amsterdam, the Netherlands, and colleagues note. “Age is not considered to be a contraindication for breast-conserving treatment, but retrospective studies have indicated that elderly patients are less likely to be treated conservatively.” In a multicenter, randomized study, the researchers examined survival, QOL, and treatment preference in elderly breast cancer patients undergoing mastectomy or tumor excision plus tamoxifen. Eligible subjects were at least 70 years of age. One hundred thirty-six patients (65 in the mastectomy group and 71 in the conservative treatment group) completed QOL questionnaires between 2 and 12 months after randomization. Duration of survival did not differ between the two groups, according to the investigators. In addition, no significant differences were observed in terms of fatigue, emotional functioning, fear of recurrence, social support, physical functioning, and leisure time activities. Patients treated with tumor excision and tamoxifen had fewer arm problems (p = 0.04) than those undergoing mastectomy, as well as a trend toward a more positive body image (p = 0.06). The authors note that 62% and 72% of patients undergoing mastectomy and conservative treatment, respectively, favored their own therapy. “The results of this study suggest that surgeons should propose tumorectomy and tamoxifen to older breast cancer patients as a reasonable alternative to mastectomy in a more systematic manner than is currently the case,” Dr. de Haes and colleagues conclude. (Source: Eur J Cancer 2003;39:945-951: Reuters Health: June 11, 2003: Oncolink)