title: Surgery and hormone therapy trends in octogenarians with invasive breast cancer.
abstract: BACKGROUND
  There has been a trend toward minimizing surgery in elderly women with estrogen receptor-positive (ER+) breast cancer.
  
  
  METHODS
  Using the National Cancer Data Base, we selected 95,357 women ≥80 years with invasive, ER+ breast cancer. Chi-square test and logistic regression were used to analyze trends in surgery and hormone therapy.
  
  
  RESULTS
  From 2004 to 2012, 90% of women were treated with surgery first and 10% were treated with primary nonoperative management. Of those undergoing nonoperative management, 72% received endocrine therapy and 27% had no treatment. The rate of primary nonoperative treatment doubled from 7% in 2004 to 14% in 2012. Multivariate logistic regression adjusted for patient, facility, and tumor factors identified more advanced clinical stage, older age, African-American race, and treatment at Academic facilities as independent predictors of receiving primary nonsurgical management.
  
  
  CONCLUSIONS
  There has been an increase over time in primary nonoperative management of ER+ breast cancer in octogenarians.
authors.affiliation: Department of Surgery, University of Chicago, Chicago, IL, USA.
authors.forename: Olga
authors.initials: O
authors.lastname: Kantor
authors.affiliation: Department of Surgery, NorthShore University HealthSystem, Evanston Hospital, Evanston, IL, USA.
authors.forename: Catherine
authors.initials: C
authors.lastname: Pesce
authors.affiliation: Department of Surgery, NorthShore University HealthSystem, Evanston Hospital, Evanston, IL, USA.
authors.forename: Erik
authors.initials: E
authors.lastname: Liederbach
authors.affiliation: Center for Biomedical Research Informatics, Research Institute, NorthShore University Health System, Evanston, IL, USA.
authors.forename: Chi-Hsiung
authors.initials: CH
authors.lastname: Wang
authors.affiliation: Department of Surgery, NorthShore University HealthSystem, Evanston Hospital, Evanston, IL, USA.
authors.forename: David J
authors.initials: DJ
authors.lastname: Winchester
authors.affiliation: Department of Surgery, NorthShore University HealthSystem, Evanston Hospital, Evanston, IL, USA. Electronic address: kyao@northshore.org.
authors.forename: Katharine
authors.initials: K
authors.lastname: Yao
mesh_terms: D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D009361:Neoplasm Invasiveness; D011960:Receptors, Estrogen; D016896:Treatment Outcome
chemical_list: D018931:Antineoplastic Agents, Hormonal; D011960:Receptors, Estrogen
keywords: Breast cancer; Elderly; Hormone therapy; Primary endocrine therapy