Determinants of early distant metastatic disease in elderly patients with breast cancer

Background: The purpose of this analysis was to determine predictors of early distant metastasis in elderly breast cancer patients receiving hormonal therapy. Methods: We analyzed data from 938 patients in the North American Fareston Tamoxifen Adjuvant Trial 65 years old to determine predictors of early metastatic disease. Results: The median patient age was 73 (range 65 to 100). With a median follow-up of 34 months, 17 patients (1.8%) developed distant metastases. The median time to distant metastasis was 21 months. On univariate analysis, significant predictors of distant metastatic disease were as follows: progesterone receptor status (P = .032), lymphovascular invasion (P = .020), tumor grade (P = .007), tumor size (P < .01). and number of metastatic nodes (P < .01). On multivariate analysis, only the number of positive nodes (P = .029) remained significant. Patients with >= 4 positive nodes were more likely to develop early metastases than those with 0 to 3 positive nodes (odds ration 20.304; 95% confidence interval 2.777-148.456, P = .003). Conclusions: Lymph node status in the elderly breast cancer patient treated with hormonal therapy alone is a strong predictor of early distant recurrence. (c) 2006 Excerpta Medica Inc. All rights reserved.