AB063. Primary hormonal therapy for women diagnosed with breast cancer ≥70

Background: Patients over the age of 65 account for 61% of breast cancer deaths. In elderly women primary endocrine therapy (PET) is often used to control disease.

Methods: A retrospective review of all newly diagnosed invasive breast cancers from January 2009 to December 2014 in a single centre was performed. We included all patients aged ≥70 at diagnosis, treated with PET. We excluded patients with a prior history of breast cancer

Results: A total of 166 patients were treated with PET. The mean age was 82.17. Fifty-two (31.3%) were prescribed an aromatase inhibitor and tamoxifen was prescribed to 46 (27.7%) patients. The mean tumour size was 2.6 cm (range, 0.3–16.0 cm). 99% of tumours were ER positive and 98% PR positive. Only 7 (5%) were HER2 positive. Five patients (3%) had documented evidence of failed PET and proceeded to have surgery. Four patients were commenced on two endocrine options prior to surgical intervention. Three of these 5 patients died; mean of 14 (range, 5–26) to death from surgery date. Patients were followed up for a mean of 39.3 months (range, 1–122 months), during which 112 (68%) died. Mean time to death was 35.2 months (range, 1–108 months). Those who survived were followed for a mean of 47.2 months (range, 1–122 months).

Conclusions: This study shows a high mortality rate associated with elderly patients treated with PET. However, few patients required surgery for local control while treated with PET. Further prospective studies are needed to generate quality data which can be used to counsel patients

Keywords: Breast surgery; elderly patients; primary hormonal therapy