{"id":13246,"date":"2023-03-14T00:00:00","date_gmt":"2023-03-14T04:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/publications\/journal-articles\/the-association-between-surgical-axillary-staging-adjuvant-treatment-use-and-survival-in-older-women-with-early-stage-breast-cancer-a-population-based-study\/"},"modified":"2023-09-20T13:38:44","modified_gmt":"2023-09-20T17:38:44","slug":"the-association-between-surgical-axillary-staging-adjuvant-treatment-use-and-survival-in-older-women-with-early-stage-breast-cancer","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/the-association-between-surgical-axillary-staging-adjuvant-treatment-use-and-survival-in-older-women-with-early-stage-breast-cancer\/","title":{"rendered":"The association between surgical axillary staging, adjuvant treatment use and survival in older women with early stage breast cancer: a population-based study"},"content":{"rendered":"

Background<\/strong> \u2014 Choosing Wisely guidelines recommend against surgical axillary staging (AS) in women \u226570 years with ER+\/HER2\u2013 early stage breast cancer (BC). This study examined the impact of AS omission on survival in older patients with BC.<\/p>\n

Methods<\/strong> \u2014 This was a population-based cohort study using health administrative data in Ontario, Canada. We identified women aged 65\u201395 years who underwent surgery for Stage I\/II BC between 2010 and 2016. Patients were weighted by propensity scores for receipt of AS that included patient and disease characteristics using overlap weights. Association with overall survival (OS) was calculated using weighted Cox models, and breast cancer-specific survival (BCSS) was calculated using weighted Fine and Gray models, adjusting for biomarkers and adjuvant treatments. Adjuvant treatment receipt was modelled with weighted log-binomial models.<\/p>\n

Results<\/strong> \u2014 Among 17,370 older women, the 1771 (10.2%) who did not undergo AS were older, more comorbid, and less likely to undergo mastectomy. Women who did not undergo AS were less likely to receive adjuvant chemotherapy (RR 0.68, 95% CI 0.57\u20130.82), endocrine therapy (RR 0.85, 95% CI 0.81\u20130.89) or radiotherapy (RR 0.69, 95% CI 0.65\u20130.74). After weighting and adjustment, there was no significant difference in BCSS (sdHR 0.98, 95% CI 0.77\u20131.25), but women who did not undergo AS had worse OS (HR 1.14, 95% CI 1.04\u20131.25). The results among 6215 ER+\/HER2\u2013 women \u226570 years undergoing SLNB vs no AS were similar.<\/p>\n

Conclusions<\/strong> \u2014 The omission of AS in older women with early stage BC was not associated with adverse BCSS, although OS was worse.<\/p>\n","protected":false},"excerpt":{"rendered":"

Background \u2014 Choosing Wisely guidelines recommend against surgical axillary staging (AS) in women \u226570 years with ER+\/HER2\u2013 early stage breast cancer (BC). This study examined the impact of AS omission on survival in older patients with BC. Methods \u2014 This was a population-based cohort study using health administrative data in Ontario, Canada. We identified women […]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[38,25,21],"migration-helper-qa-sample-set":[],"class_list":["post-13246","journal_article","type-journal_article","status-publish","hentry","topic-cancer-and-cancer-screening","topic-surgery","topic-women-or-gender-based-research"],"acf":{"citation":"Castelo M, Sutradhar R, Faught N, Mata DGMM, Hahn E, Nguyen L, Paszat L, Rodin D, Trebinjac S, Fong C, Rakovitch E. Ann Surg Oncol<\/em>. 2023; 30(7):3901-12. Epub 2023 Mar 14.","source_url":"https:\/\/doi.org\/10.1245\/s10434-023-13274-0","ices_scientist":[1099,1370,1341],"site":[6733],"research_program":[6741],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"068DF42A-2D62-4907-8CA9-EC2EDCB9FD79","sitecore_item_name":"The-association-between-surgical-axillary-staging-adjuvant-treatment-use-and-survival","sitecore_field_values":"{\n \"Title\": \"The association between surgical axillary staging, adjuvant treatment use and survival in older women with early stage breast cancer: a population-based study\",\n \"Short title\": \"The association between surgical\",\n \"Summary\": \"This study found that the omission of axillary staging in older women with early stage breast cancer was not associated with adverse breast cancer-specific survival.\",\n \"Citation\": \"

Castelo M, Sutradhar R, Faught N, Mata DGMM, Hahn E, Nguyen L, Paszat L, Rodin D, Trebinjac S, Fong C, Rakovitch E. Ann Surg Oncol<\/em>. 2023; Mar 14 [Epub ahead of print]. DOI: https:\/\/doi.org\/10.1245\/s10434-023-13274-0<\/a><\/p>\",\n \"Abstract\": \"

Background<\/strong> — Choosing Wisely guidelines recommend against surgical axillary staging (AS) in women ≥70 years with ER+\/HER2– early stage breast cancer (BC). This study examined the impact of AS omission on survival in older patients with BC.<\/p>n

Methods<\/strong> — This was a population-based cohort study using health administrative data in Ontario, Canada. We identified women aged 65–95 years who underwent surgery for Stage I\/II BC between 2010 and 2016. Patients were weighted by propensity scores for receipt of AS that included patient and disease characteristics using overlap weights. Association with overall survival (OS) was calculated using weighted Cox models, and breast cancer-specific survival (BCSS) was calculated using weighted Fine and Gray models, adjusting for biomarkers and adjuvant treatments. Adjuvant treatment receipt was modelled with weighted log-binomial models.<\/p>n

Results<\/strong> — Among 17,370 older women, the 1771 (10.2%) who did not undergo AS were older, more comorbid, and less likely to undergo mastectomy. Women who did not undergo AS were less likely to receive adjuvant chemotherapy (RR 0.68, 95% CI 0.57–0.82), endocrine therapy (RR 0.85, 95% CI 0.81–0.89) or radiotherapy (RR 0.69, 95% CI 0.65–0.74). After weighting and adjustment, there was no significant difference in BCSS (sdHR 0.98, 95% CI 0.77–1.25), but women who did not undergo AS had worse OS (HR 1.14, 95% CI 1.04–1.25). The results among 6215 ER+\/HER2– women ≥70 years undergoing SLNB vs no AS were similar.<\/p>n

Conclusions<\/strong> — The omission of AS in older women with early stage BC was not associated with adverse BCSS, although OS was worse.<\/p>\",\n \"ICES Scientists\": \"{F137150D-7BD5-4368-8FCC-FAF6D82891C4}|{56BF24FA-D81E-4114-BF1F-4715A424E26C}|{CFFF9366-6EFD-41AF-8E1E-5C38A65A0CE9}\",\n \"Posted Date\": \"20230314T000000\",\n \"Show on Publications Landing Page\": \"1\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2023\/March\/The-association-between-surgical-axillary-staging-adjuvant-treatment-use-and-survival"},"yoast_head":"\nICES | The association between surgical axillary staging, adjuvant treatment use and survival in older women with early stage breast cancer: a population-based study<\/title>\n<meta name=\"description\" content=\"Background \u2014 Choosing Wisely guidelines recommend against surgical axillary staging (AS) in women \u226570 years with ER+\/HER2\u2013 early stage breast cancer (BC).\" \/>\n<meta name=\"robots\" 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