Tumorectomy plus tamoxifen for the treatment of breast cancer in the elderly.

Between 1987 and 1991 a total of 37 breast cancer patients with a mean age of 78.8 (68-89) years underwent local tumor excision and were continuously given 20-30 mg tamoxifen. Thirteen patients presented with clinical stage I, 21 with stage II, two patients with stage III and one woman with stage IV. Surgical complications were minimal and hospital stay 3.5 days. Four patients were lost to follow-up. After a mean observation time of 44.5 months, three of the remaining patients developed local recurrence, which was excised, and 12 patients (32.4%) died. Death, however, was never related to breast cancer. One further patient developed visceral metastases after 46 months of treatment, which responded well to an increase in tamoxifen. The patient with osseous metastases at the time of diagnosis is still alive with stable disease after 75 months. Growing axillary lymph nodes were dissected 16 and 22 months after primary surgery in two patients. It is concluded from this series that limited surgery with hormonal therapy is an effective treatment of breast cancer in elderly patients.