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Introduction <p>Oncologic outcome data on women with neither SLNB nor radiation are limited. We evaluated recurrence and survival in older women with early stage, ER+/HER2 negative breast cancer who underwent lumpectomy without SLNB or radiation.</p> Patients and Methods <p>Women treated for breast cancer from 2014 to 2022 were identified in a local tumor registry. Inclusion criteria were women 65 years and older, tumor size ≤ 5 cm, ER+ &gt; 10%, HER2- invasive breast cancers treated with lumpectomy without SLNB or radiation. The Kaplan–Meier method was used to estimate curves for mortality and recurrence.</p> Results <p>A total of 116 women met inclusion criteria. Median age at time of surgery was 76 (IQR: 72–80) years. The majority of patients were white (85%). Most patients had a T1 tumor (85%) and ductal histology (78%). In total, 107 patients (92%) initiated adjuvant endocrine therapy with median therapy duration of 4.2 years. Of the 116 patients, 7 developed recurrence (6.0%). Of the seven recurrences, all were initially locoregional: six in breast and one axillary. Three women with recurrence underwent mastectomy (5 year mastectomy-free survival 97.4%).</p> Discussion <p>Locoregional recurrence was rare at a median follow up of over 5 years with simultaneous omission of SLNB and radiation in older women with early stage ER+, HER2- breast tumors. Death from non cancer causes was more common, highlighting the competing risks in this population. These findings support the oncologic safety of this approach in well selected patients—older women with low risk tumors.</p>

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Simultaneous Omission of Sentinel Lymph Node Biopsy and Radiation in Older Women with Early ER+ Breast Cancer

  • 期刊论文

  • 发表日期：

    2025年10月27日

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  • Chase E. Cox,
  • Jessica Schumacher,
  • Margaret Lillie,
  • Joshua Carino,
  • Yash Agrawal,
  • Julia M. Selfridge,
  • Kristalyn K Gallagher,
  • David W. Ollila,
  • Dana L. Casey,
  • Caprice C. Greenberg,
  • Philip M. Spanheimer

摘要

Introduction

Oncologic outcome data on women with neither SLNB nor radiation are limited. We evaluated recurrence and survival in older women with early stage, ER+/HER2 negative breast cancer who underwent lumpectomy without SLNB or radiation.

Patients and Methods

Women treated for breast cancer from 2014 to 2022 were identified in a local tumor registry. Inclusion criteria were women 65 years and older, tumor size ≤ 5 cm, ER+ > 10%, HER2- invasive breast cancers treated with lumpectomy without SLNB or radiation. The Kaplan–Meier method was used to estimate curves for mortality and recurrence.

Results

A total of 116 women met inclusion criteria. Median age at time of surgery was 76 (IQR: 72–80) years. The majority of patients were white (85%). Most patients had a T1 tumor (85%) and ductal histology (78%). In total, 107 patients (92%) initiated adjuvant endocrine therapy with median therapy duration of 4.2 years. Of the 116 patients, 7 developed recurrence (6.0%). Of the seven recurrences, all were initially locoregional: six in breast and one axillary. Three women with recurrence underwent mastectomy (5 year mastectomy-free survival 97.4%).

Discussion

Locoregional recurrence was rare at a median follow up of over 5 years with simultaneous omission of SLNB and radiation in older women with early stage ER+, HER2- breast tumors. Death from non cancer causes was more common, highlighting the competing risks in this population. These findings support the oncologic safety of this approach in well selected patients—older women with low risk tumors.