Surgery and hormone therapy trends in octogenarians with invasive breast cancer

Background: There has been a trend toward minimizing surgery in elderly women with estrogen receptor-positive (ER+) breast cancer.

Methods: Using the National Cancer Data Base, we selected 95,357 women ≥80 years with invasive, ER+ breast cancer. Chi-square test and logistic regression were used to analyze trends in surgery and hormone therapy.

Results: From 2004 to 2012, 90% of women were treated with surgery first and 10% were treated with primary nonoperative management. Of those undergoing nonoperative management, 72% received endocrine therapy and 27% had no treatment. The rate of primary nonoperative treatment doubled from 7% in 2004 to 14% in 2012. Multivariate logistic regression adjusted for patient, facility, and tumor factors identified more advanced clinical stage, older age, African-American race, and treatment at Academic facilities as independent predictors of receiving primary nonsurgical management.

Conclusions: There has been an increase over time in primary nonoperative management of ER+ breast cancer in octogenarians.