Breast conservation in elderly women for clinically negative axillary lymph nodes without axillary dissection

Background. A prospective study was initiated to explore an approach of limited therapy in elderly patients with early clinical stage breast cancer. Methods. Between 1982 and 1989, 73 women with American Joint Committee on Cancer Stage I/II, clinically negative axillary lymph nodes aged 65 years or older (median age, 74 years) were enrolled in a treatment program consisting of tumor excision, breast and regional lymph node irradiation, and, in 66 patients, tamoxifen. Patients were assessed for disease outcome and complications. Results. At a median follow‐up of 54 months, 8‐year rates of local and regional lymph node control were 92.5% and 100%, respectively. Eight‐year probabilities of disease free, overall, and breast cancer specific survival were 84%, 52.5%, and 93.8%, respectively. There was minimal morbidity associated with either regional irradiation or tamoxifen. Conclusions. An approach to early breast cancer in the elderly that seeks to limit the aggressiveness of local and systemic therapies appears to result in a satisfactory disease outcome with few complications.