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

Authors

  • 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.


     

    Interessenskonflikt

    Ich erkläre als korrespondierender Autor, dass meine Koautoren mir mitgeteilt haben, dass sie während der letzten 3 Jahre keine wirtschaftlichen oder persönlichen Verbindungen im oben genannten Sinne hatten. Auch ich selbst hatte keine derartigen Verbindungen in den letzten 3 Jahren.

    Publication History

    Article published online:
    21 June 2022

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