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Title: Anastrozole for 6 Months Aids Breast Conservation in Older Women: Presented at SSO

"Anastrozole for 6 Months Aids Breast Conservation in Older Women: Presented at SSO"

By Michael Smith ATLANTA, GA -- March 4, 2005 -- Neo-adjuvant therapy with aromatase inhibitors for 6 months can allow breast-conserving surgery even in elderly women, according to a presentation made here March 3[^rd at the Society of Surgical Oncology 58^th Annual Cancer Symposium.

"Old patients like to keep their breasts," said Dr. Rémy Salmon, MD, chief of the department of surgery, Institut Curie, Paris, France. Breast-conserving surgery was possible in 86% of 75 women treated, he said, and the remaining 10 women had mastectomies.

The new wrinkle, he said, is that the women were treated with the aromatase inhibitor anastrozole for 6 months before surgery, rather than the usual 3 months.

All but one of the women saw their tumors shrink as a result of the anastrozole therapy, he said.

In the prospective study, 75 women who ranged in age from 58 to 91 (mean age 75 years) were found to have infiltrative cancer confirmed by biopsy. The initial size of their tumors ranged from 15 to 90 mm in diameter.

Dr. Salmon noted that there was no change in the women's estrogen-receptor status during the anastrozole treatment, unlike the effect of tamoxifen, which reduces the number of estrogen-positive receptors.

"[Estrogen-receptor] positivity is necessary to give aromatase inhibitors," Dr. Salmon said, "but you don't have to keep checking [the patient's estrogen receptor status]."

The results show that neoadjuvant treatment is feasible in older women, making conservative surgery possible in many cases, he said, but that treatment should be at least 6 months in duration to obtain the greatest possible shrinkage of the tumor.

In France, 25% of breast cancers appear in women who are older than 70 years and 10% in women older than 80, so that a range of surgical options is essential, Dr. Salmon said in an interview.

Indeed, he said, it is likely that the numbers will continue to grow. "Seventy-five is not old in our days," he said. "You have to treat older patients the same way as you treat younger patients."

[Presentation title: Breast Cancer Neo-adjuvant Treatment with Aromatase Inhibitors (AI) in Old Patients -- Hormonal Receptors Evolution. Abstract P41]

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