Omissions rollback.

We have randomized data that it’s relatively safe to omit adjuvant radiation in older women with early stage breast cancer who take endocrine therapy (ET). What’s happened since then? Radiation regimens have gotten much shorter, endocrine therapy duration has gotten much longer, and population data has shown us that fewer than half of patients actually comply with their intended endocrine therapy regimen. So, why not consider omitting the ET? We’ve recently seen a Markov model simulating such a randomization, and here we have data from the national cancer database (NCDB) comparing survival outcomes for either radiation alone or ET alone after lumpectomy. Included cases had to be 70 or older with hormone-receptor positive, HER2 negative, T1 breast cancer. Among the nearly 3000 cases, two thirds received ET alone while the other third received radiation alone. At 5 years, there was no difference in the overall survival rate between groups. TBL: Despite the limitations of NCDB analyses, there again appears to be no difference in outcomes when omitting adjuvant endocrine therapy in favor of breast radiation in older women with early stage breast cancer. | Buszek, Int J Radiat Oncol Biol Phys 2019