Breast-Conserving Surgery With or Without Radiotherapy in Older Breast Patients With Early Stage Breast Cancer: A Systematic Review and Meta-analysis

Abstract

Although patients who received radiotherapy had a lower relative risk of locoregional recurrence, the absolute risk was low, and overall survival was not affected. We propose that the debate should not only focus on the relative risk but also on the absolute benefit of radiotherapy and the number needed to treat. Both treatment options may be reasonable in clinical practice.

AGO Recommendations for the Diagnosis and Treatment of Patients with Early Breast Cancer: Update 2016

“…However, for elderly patients there is no impact of postoperative radiotherapy on breast cancerrelated survival. There are more severe cardiovascular events after radiotherapy of the breast [56,[85][86][87][88][89].…”

Variations in compliance to quality indicators by age for 41,871 breast cancer patients across Europe: A European Society of Breast Cancer Specialists database analysis

“…In the last decade, several studies have documented the omission of certain treatments. A small number of clinical trials omitting radiotherapy for selected groups of older, HR positive patients, have been performed [28] none of them showing a deterred survival. However, the risk of locoregional recurrence was higher, as was also shown in the EBCTCG overview [29], and recently confirmed in the PRIME II trial [30].…”

The comparative oncologic effectiveness of available management strategies for clinically localized prostate cancer

“…4 The number needed to treat to prevent one death at 18 years of follow-up was 8, lower among men under the age of 65, comparing favorably to the breast cancer literature. 5 Second, in addition to overall survival, RP improves cancer-specific survival among men with localized prostate cancer. The initial publication of the SPCG-4 revealed an absolute difference in prostate cancer specific mortality of 2% at 5 years and 6.6% at 8 years in favor of prostatectomy.…”