Background: Cytotoxic chemotherapy for breast cancer after surgery is one of the most important systemic therapy to reduce the recurrence rates and mortality rates. However, chemotherapy in elderly women with low risk, hormone receptor positive breast cancer is still inspires controversy. We report the outcomes in postmenopausal women with hormone receptor positive, HER-2 negative T2N0 breast cancer without adjuvant chemotherapy.
Methods: We analyzed retrospectively 207 postmenopausal women with hormone receptor positive, HER-2 negative T2N0 invasive breast cancer who underwent surgery at Asan Medical Center (Seoul, South Korea) from January 2000 to December 2008. The patients were devided two groups: endocrine therapy only (ET, n = 71) and adjuvant chemotherapy followed by endocrine therapy (CET, n = 136).
Results: ET group was older (p<0.001) and less received adjuvant radiotherapy (p=0.003) than CET group. There was more lymphovascular invasion in CET group than ET group (p=0.001). ET group showed a higher degree of progesterone receptor expression (p=0.048). In multivariate analysis, lymphovascular invasion was the only factor affecting risk of death and recurrence. There was no statistical significance in disease free survival rate, overall survival rate and disease-specific survival rate between two groups.
Conclusions: Some postmenopausal women with hormone receptor positive, HER-2 negative T2N0 breast cancer may avoid chemotherapy on the basis of biologic characteristics, comorbidity, social support, functional status, and patient’s preferences. Tailored adjuvant therapy for early-stage breast cancer patients is an important goal.