Impact of whole breast irradiation, endocrine therapy or their combination on outcomes of early-stage, luminal A-like, low-risk, breast cancer patients aged 65 years or over: insights from the EUSOMA database
Menée à partir de données européennes 2010-2022 portant sur 9 660 patientes âgées d'au moins 65 ans et atteintes d’un cancer du sein de stade précoce à faible risque de récidive (durée médiane de suivi : 1,87 ans), cette étude évalue les taux de récidive, la survie spécifique et la mortalité en fonction du traitement reçu à la suite d'une chirurgie conservatrice (hormonothérapie seule, radiothérapie du sein entier seule, hormonothérapie et radiothérapie combinées ou absence de traitement adjuvant)
Aim: To assess oncological outcomes in early-stage, luminal A-like, low-risk, breast cancer patients aged 65 years or more after conserving surgery followed by endocrine therapy (ET) and/or whole breast irradiation (WBI) or no adjuvant therapy.
Methods: Data from patients treated in EUSOMA-certified breast units between 2010 and 2022 were collected. Univariable and multivariable analyses for local, nodal, distant recurrences, breast cancer specific survival (BCSS), and overall mortality were conducted. Potential treatment-related determinants included adjuvant ET alone, WBI alone, ET+WBI or no adjuvant therapy.
Results: Breast cancer patients (9,660) from 72 Breast Units across 14 European countries were enrolled. Tumours were pT1 in 85.8% of cases. All tumours were luminal A-like. All patients had negative nodes. Adjuvant ET alone was prescribed for 806 (8.3%) and WBI alone was delivered to 386 (4.0%); ET and WBI were combined (ET+WBI) in 8,154 (84.4%) patients. No adjuvant therapy was given to 314 patients (3.3%). The median follow-up was 1.87 years (first quartile 0.81, third quartile 4.16), and the mean was 2.62 years (range 0.003-13.82 years). Compared with no adjuvant therapy, multivariable analysis showed ET+WBI significantly improved in-breast tumour recurrence-free survival (IBTRFS) (HR 0.28, CI 95% 0.10−0.79; p=0.016) and BCSS (HR 0.12; CI 95%: 0.03−0.51; p=0.004). ET alone (HR 0.57; CI 95%: 0.35−0.90; p=0.017), WBI alone (HR 0.51; CI 95%: 0.27−0.95; p=0.033) and both treatments combined (HR 0.26; CI 95%: 0.16−0.42; p<0.001) significantly lowered mortality.
Conclusions: Despite a short follow-up, results from this large series of low-risk breast cancer patients who had undergone conserving surgery, showed adjuvant treatments impacted positively upon outcomes.
European Journal of Cancer , résumé, 2026