Overtreating Older Women with Breast Cancer May Cause More Harm than Good, Study Finds

A new study found overtreating older women (over 70) with breast cancer might be detrimental, while not improving survival or recurrence. The study was published in JAMA Network Open.

“As a breast surgeon, I want to give my patients the best chance of survival with the best quality of life,” said senior author Priscilla McAuliffe, M.D., Ph.D., surgical oncologist at UPMC Hillman Cancer Center and attending surgeon in the Department of Surgery at the University of Pittsburgh School of Medicine via a press release. “However, we have found that overtreatment of early-stage breast cancer in older patients may actually cause harm while not improving recurrence or survival rates.”

Researchers assessed data from more than 3,000 women over the age of 70 who were diagnosed with ER-positive, HER2-negative breast cancer from 2010 to 2018. The data were obtained from 15 community and academic sites, and were evaluated with the UPMC Network Cancer Registry.
The investigators looked into the efficacy of two procedures: sentinel lymph node biopsy (SLNB), and radiotherapy (RT). They found that the number of SLNB and RT procedures among patients over age 70 were 65.3% and 54.4%, respectively. Importantly, the researchers observed that the rates of breast cancer recurrence  or survival remained unchanged for treated versus untreated patients.
“This study is an example of how we can use big data to deliver on the promise of precision medicine—getting the right treatment to the right patient at the right time,” said Adrian Lee, Ph.D., investigator at the Women’s Cancer Research Center at UPMC Hillman Cancer Center and Magee Womens Research Institute, and director of the UPMC/Pitt Institute of Precision Medicine. “Sometimes—as it happens to be in this case—that could mean deciding not to provide a certain treatment to ensure better care for the patient.”