title: Omission of adjuvant radiation therapy in elderly patients with low risk breast cancer undergoing breast-conserving surgery--two center experience.
abstract: BACKGROUND
  Breast cancer is, now often diagnosed in patients older than 70 years due to longer life expectancy. The usual treatment is mastectomy to obviate radiotherapy or breast-conserving surgery followed by radiotherapy. The aim of this study was to investigate the need for adjuvant radiotherapy in older patients and the consequences of omitting radiotherapy following conservative surgery.
  
  
  METHODS
  An extensive database search was made of patients who had been treated for breast cancer at the Department of Oncology, University Hospital Olomouc and the Atlas Hospital in Zlin (2004-2008). We identified 738 patients of whom 190 patients (25.7%) were older than 70 years of age. These were followed up for progression-free and overall survival. The cause of death was checked for breast cancer relapse.
  
  
  RESULTS
  In total only 9 patients undergoing breast saving surgery were ultimately identified. No patient had confirmed local recurrence during the follow up period: Two patients have died due to distant metastasis without local relapse and one patient has died for reasons other than breast cancer.
  
  
  CONCLUSIONS
  Omitting radiotherapy after breast saving surgery provides an opportunity for women to undergo breast saving surgery and avoid 7 weeks of radiotherapy. This could significantly improve patient quality of life. In our of many years experience and from published randomized data, this procedure is safe for a select group of patients 70 years of age and older.
authors.affiliation: Department of Oncology, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic.
authors.forename: David
authors.initials: D
authors.lastname: Vrana
authors.forename: Jiri
authors.initials: J
authors.lastname: Gatek
authors.forename: Lucie
authors.initials: L
authors.lastname: Lukesova
authors.forename: Tomas
authors.initials: T
authors.lastname: Vazan
authors.forename: Bohuslav
authors.initials: B
authors.lastname: Melichar
authors.forename: Marketa
authors.initials: M
authors.lastname: Pospiskova
authors.forename: Ivan
authors.initials: I
authors.lastname: Svach
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental; D011379:Prognosis; D018714:Radiotherapy, Adjuvant / Q000706:statistics & numerical data; D015996:Survival Rate; D016896:Treatment Outcome