Resumen
This study investigated the outcomes of primary endocrine therapy (PET) compared to surgery for treating older women (=70 years) with early-stage oestrogen-receptor-positive breast cancer, specifically considering the impact of patients? frailty and comorbidity levels. Using UK data from 2000 to 2016, the researchers analysed the all-cause mortality and breast cancer-specific mortality among 23,109 patients, stratified by their Charlson comorbidity index and hospital frailty risk score. The findings showed that surgery generally resulted in better overall survival rates compared to PET in patients with higher levels of frailty or comorbidity. Notably, in very frail older women, there was no significant difference in breast cancer-specific mortality between PET and surgery arms. The study concludes that PET could be a viable treatment option for frail older women with early-stage breast cancer, considering the minimal survival benefits offered by surgery in this subgroup.