Effect of surgery on breast cancer-specific mortality in older adults with endocrine receptor-positive and HER2-negative breast cancer

Objective: Standard treatment modalities, including surgery, are desirable, even in older adults with breast cancer. However, frailty and comorbidities may limit surgery. This study aimed to evaluate whether endocrine therapy (ET) is associated with a lower survival rate than a standard surgical regimen. Patients and Methods: In this retrospective observational study, older adults (aged ≥75 years) diagnosed with nonmetastatic hormone receptor-positive, HER2-negative, primary breast cancer who were treated between 2006 and 2022 were evaluated in the ET (n=33) and surgery (n=95) groups. Survival status and cause of death were analyzed by estimating the overall survival (OS) and breast cancer-specific survival (BCSS) rates. Univariate and multivariate analyses were performed to identify survival-associated factors. Propensity score matching (PSM) was used to reduce the effect of selection bias. Conclusion: ET may be an appropriate treatment option for older adults with breast cancer without sufficient life expectancies.