title: Primary Hormone Therapy in Elderly Women with Hormone-Sensitive Locoregional Breast Cancer: Endocrine Therapy Alone Is a Reasonable Alternative in Selected Patients.
abstract: BACKGROUND
  Treatment with aromatase inhibitors (AIs) followed by surgery is often recommended for women with locoregional hormone-sensitive breast cancer. However, no study has compared the efficacy of AIs alone versus AIs followed by surgery.
  
  
  METHODS
  33 postmenopausal breast cancer patients were treated with primary hormone therapy. Estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor type 2 receptor (HER2) expression levels were analyzed by immunohistochemistry. After hormone therapy, eligible patients underwent surgery, and those who were not candidates for surgery continued on hormone therapy. We retrospectively analyzed time to progression, overall survival, response, and impact of surgery on outcome.
  
  
  RESULTS
  All patients were ER+. HER2 was successfully analyzed in 30 patients, all of whom were HER2-. The median time to progression was 94 months, and the median overall survival was not reached, while the mean overall survival was 123 months. The overall response rate was 63.6%, with 9.1% complete responses. No significant differences in time to progression or survival were observed between patients who underwent surgery and those who did not.
  
  
  CONCLUSIONS
  Primary hormone therapy with AIs is effective in elderly breast cancer patients with high levels of hormone receptors and may provide a feasible and tolerable alternative to surgery in selected hormone-sensitive breast cancer patients.
authors.affiliation: Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Spain.
authors.forename: Vanesa
authors.initials: V
authors.lastname: Quiroga-García
authors.affiliation: Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Spain.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Cirauqui-Cirauqui
authors.affiliation: Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Bugés-Sánchez
authors.affiliation: Gynecology and Obstetrics Service, Hospital Germans Trias i Pujol, Badalona, Spain.
authors.forename: Miguel Ángel
authors.initials: MÁ
authors.lastname: Luna-Tomás
authors.affiliation: Pathology Service, Hospital Germans Trias i Pujol, Badalona, Spain.
authors.forename: Eva María
authors.initials: EM
authors.lastname: Castellà-Fernández
authors.affiliation: Radiology Service, Hospital Germans Trias i Pujol, Badalona, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Mariscal-Martínez
authors.affiliation: Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Spain.
authors.forename: Mireia
authors.initials: M
authors.lastname: Margelí-Vila
keywords: ER/PR+/HER2–; Hormone therapy; Locoregional breast cancer; Surgery