title: Determinants of early distant metastatic disease in elderly patients with breast cancer.
abstract: BACKGROUND
  The purpose of this analysis was to determine predictors of early distant metastasis in elderly breast cancer patients receiving hormonal therapy.
  
  
  METHODS
  We analyzed data from 938 patients in the North American Fareston Tamoxifen Adjuvant Trial>or=65 years old to determine predictors of early metastatic disease.
  
  
  RESULTS
  The median patient age was 73 (range 65 to 100). With a median follow-up of 34 months, 17 patients (1.8%) developed distant metastases. The median time to distant metastasis was 21 months. On univariate analysis, significant predictors of distant metastatic disease were as follows: progesterone receptor status (P=.032), lymphovascular invasion (P=.020), tumor grade (P=.007), tumor size (P<.01), and number of metastatic nodes (P<.01). On multivariate analysis, only the number of positive nodes (P=.029) remained significant. Patients with >or=4 positive nodes were more likely to develop early metastases than those with 0 to 3 positive nodes (odds ration 20.304; 95% confidence interval 2.777-148.456, P=.003).
  
  
  CONCLUSIONS
  Lymph node status in the elderly breast cancer patient treated with hormonal therapy alone is a strong predictor of early distant recurrence.
authors.affiliation: Division of Surgical Oncology, Department of Surgery, University of Louisville, 315 E. Broadway, Suite 312, Louisville, KY 40202, USA. anees.chagpar@nortonhealthcare.org
authors.forename: Anees B
authors.initials: AB
authors.lastname: Chagpar
authors.forename: Kelly M
authors.initials: KM
authors.lastname: McMasters
authors.forename: Robert C
authors.initials: RC
authors.lastname: Martin
authors.forename: Cynthia
authors.initials: C
authors.lastname: Thoene
authors.forename: Jacob Y
authors.initials: JY
authors.lastname: Nurko
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Edwards
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D002277:Carcinoma / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008408:Mastectomy; D012307:Risk Factors; D013629:Tamoxifen / Q000627:therapeutic use; D013997:Time Factors; D017312:Toremifene / Q000627:therapeutic use
chemical_list: D018931:Antineoplastic Agents, Hormonal; D013629:Tamoxifen; D017312:Toremifene