Immediate vs. Deferred Breast Surgery in Women Aged 70+

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We’re reporting live from the San Antonio Breast Cancer Symposium (SABCS) 2024, where new research is shaping the future of breast cancer care. One of the highlights so far is a study addressing a critical question for women aged 70 and older with operable breast cancer: Is immediate surgery necessary, or can it safely be delayed?

Presented by Robert Hills, this patient-level meta-analysis provides important insights into the benefits of early surgical intervention. Here’s what the data revealed and what it means for the future of breast cancer treatment.

A new meta-analysis sheds light on a long-debated question in breast cancer treatment for older women: Should surgery be performed immediately or only if the cancer progresses?

 

  • The study analyzed data from three clinical trials involving 1,082 women aged 70 and older with operable early breast cancer. All participants received tamoxifen, a hormone therapy, for at least five years, but the trials compared outcomes between women who had immediate breast surgery and those who deferred surgery unless their cancer advanced.
  • The results: immediate surgery significantly reduced the risk of cancer returning in the breast area (locoregional failure). Within five years, 12.1% of women who had surgery experienced locoregional failure compared to 45.8% in the deferred surgery group.
  • Immediate surgery also showed long-term benefits, including lowering the risk of the cancer spreading to other parts of the body (distant recurrence) and reducing breast cancer-related deaths by about half after five years. Interestingly, these benefits became more apparent over time, with fewer recurrences and deaths occurring after the initial few years.

 

This study highlights the importance of early surgical intervention, even in older women, and provides valuable insights for designing future treatment plans. While endocrine therapy alone may seem like a less invasive option, the long-term outcomes emphasize the protective role of surgery in managing breast cancer.

For more updates on breast cancer research and progress, visit Breast Cancer Canada.
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