Senologie - Zeitschrift für Mammadiagnostik und -therapie 2022; 19(02): e15-e16
DOI: 10.1055/s-0042-1748377
Abstracts | DGS

Adherence to multidisciplinary tumor board recommendation in elderly patients with HER2-positive breast cancer

F. Geissler
1   University Hospital Basel, University of Basel, Gynecological Cancer Center, Basel, Schweiz
2   University Hospital Basel, University of Basel, Breast Cancer Center, Basel, Schweiz
,
N. Maggi
2   University Hospital Basel, University of Basel, Breast Cancer Center, Basel, Schweiz
3   University Hospital Zurich, University of Zürich, Breast Cancer Center, Zürich, Schweiz
,
A. Brülhart
1   University Hospital Basel, University of Basel, Gynecological Cancer Center, Basel, Schweiz
,
C. Kurzeder
1   University Hospital Basel, University of Basel, Gynecological Cancer Center, Basel, Schweiz
2   University Hospital Basel, University of Basel, Breast Cancer Center, Basel, Schweiz
,
M. Vetter
4   Cantonal Hospital Baselland, Department of Oncology and Hematology, Liestal, Schweiz
,
V. Heinzelmann-Schwarz
1   University Hospital Basel, University of Basel, Gynecological Cancer Center, Basel, Schweiz
2   University Hospital Basel, University of Basel, Breast Cancer Center, Basel, Schweiz
,
K. Dedes
3   University Hospital Zurich, University of Zürich, Breast Cancer Center, Zürich, Schweiz
,
F. Schwab
1   University Hospital Basel, University of Basel, Gynecological Cancer Center, Basel, Schweiz
2   University Hospital Basel, University of Basel, Breast Cancer Center, Basel, Schweiz
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Objective Approximately 45% of new breast cancer (BC) cases are diagnosed in women aged >65years. Nevertheless, elderly cancer patients are consistently underrepresented in clinical trials. Furthermore, preexisting diseases, which might limit treatment options, occur frequently among these patients. Different studies have shown some approaches in de-escalating strategies in elderly patients. Nevertheless, there is still a paucity of research evaluating deviations from therapy guidelines in elderly HER2+ BC patients.

Method A retrospective multicenter cohort study to assess the outcome of elderly HER2-positive BC patients in accordance with adherence to the expert treatment recommendation was performed. The study included all women age 65 and older, diagnosed with a HER2-positive BC (stage I-IV) from January 2012 to December 2020 at the Breast Cancer Center of the University Hospital of Basel and the University Hospital of Zürich. A discordant treatment was defined as a treatment deviation from the interdisciplinary tumor board recommendation.

Results We included 108 HER2-positive BC patients with a mean age of 73 years in the study. The cohort consist of 22,7% BC patients with UICC stage I (24/106), 42,5% stage II (45/106), 17% stage III (18/106) and 17,9% stage IV (19/106). In 52,8% a discordant treatment was detected (57/108). The mean age was significantly higher in the discordant group (79 years vs 70 years, p <0.001). In 30,9% (17/52) of the cases the decision for discordant treatment was made by the physician. Despite the fact, that the main reason for discordant treatment was treatment rejection by the patient (52.7%; 29/52), we observed no significant difference in the median progression-free survival (PFS) and overall survival (OS) after 96 months of follow-up. Surprisingly, no difference in survival was noticed also in patients > 80 years of age. There was one treatment-related death recorded.

Conclusion Despite non-adherence to recommendation, we were unable to show a significant difference in PFS or OS for elderly patients after a 96 months follow-up. Therefore, treatment de-escalating could be considered in selected elderly patients with Her2 positive BC and low to intermediate risk.



Publication History

Article published online:
21 June 2022

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