Evidence map›Paper›PMID 33760065›Full record

Observational studyThe British journal of surgery2021

Bridging the age gap in breast cancer: impact of omission of breast cancer surgery in older women with oestrogen receptor-positive early breast cancer on quality-of-life outcomes.

J L Morgan, A Shrestha, M W R Reed, E Herbert, M Bradburn, S J Walters, C Martin, K Collins, S Ward, G Holmes and 25 more

Open access · bronzeAbstract readComparative StudyMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in The British journal of surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
0.9field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 2 syntheses or guidelines pooled it, 15 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Survivorship Issues in Older Adults with Breast Cancer.Current breast cancer reports · 2025
    Article
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

35 authors at 15 institutions in 3 countries.

J L MorganDepartment of Oncology and Metabolism, University of Sheffield Medical School, Sheffield, UK.ORCID 0000-0002-5337-5581
A ShresthaDepartment of Oncology and Metabolism, University of Sheffield Medical School, Sheffield, UK.
M W R ReedBrighton and Sussex Medical School, Brighton, UK.ORCID 0000-0001-7442-2132
E HerbertClinical Trials Research Unit, School for Health and Related Research, University of Sheffield, Sheffield, UK.
M BradburnClinical Trials Research Unit, School for Health and Related Research, University of Sheffield, Sheffield, UK.
S J WaltersClinical Trials Research Unit, School for Health and Related Research, University of Sheffield, Sheffield, UK.
C MartinDepartment of Oncology and Metabolism, University of Sheffield Medical School, Sheffield, UK.
K CollinsFaculty of Health and Wellbeing, Department of Allied Health Professions, Sheffield Hallam University, Sheffield, UK.
S WardDepartment of Health Economics and Decision Science, School for Health and Related Research, ScHARR, University of Sheffield, Sheffield, UK.ORCID 0000-0002-3344-0913
G HolmesDepartment of Health Economics and Decision Science, School for Health and Related Research, ScHARR, University of Sheffield, Sheffield, UK.ORCID 0000-0002-8861-9638
M BurtonClinical Trials Research Unit, School for Health and Related Research, University of Sheffield, Sheffield, UK.
K LiffordDivision of Population Medicine, Cardiff University, Cardiff, UK.
A EdwardsDivision of Population Medicine, Cardiff University, Cardiff, UK.
A RingDepartment of Medical Oncology, Royal Marsden Hospital, London, UK.
T RobinsonDepartment of Cardiovascular Sciences and National Institute for Health Research Biomedical Research Centre, University of Leicester, Cardiovascular Research Centre, Glenfield General Hospital, Leicester, UK.
T ChaterClinical Trials Research Unit, School for Health and Related Research, University of Sheffield, Sheffield, UK.
K PembertonClinical Trials Research Unit, School for Health and Related Research, University of Sheffield, Sheffield, UK.
A BrennanDepartment of Health Economics and Decision Science, School for Health and Related Research, ScHARR, University of Sheffield, Sheffield, UK.
K L CheungSchool of Medicine, University of Nottingham, Royal Derby Hospital, Derby, UK.
A ToddDepartment of Oncology and Metabolism, University of Sheffield Medical School, Sheffield, UK.
R AudisioDepartment of Surgery, University of Gothenberg, Sahlgrenska Universitetssjukhuset, Gothenberg, Sweden.
J WrightBrighton and Sussex Medical School, Brighton, UK.
R SimcockBrighton and Sussex Medical School, Brighton, UK.
A M ThomsonDepartment of Surgery, Baylor College of Medicine, Houston, Texas, USA.
M GosneySchool of Psychology and Clinical Language Sciences, University of Reading, Reading, UK.
M HattonSheffield Teaching Hospitals NHS Foundation Trust, Weston Park Hospital, Sheffield, UK.
T GreenNorth Trent Cancer Research Network Consumer Research Panel, Sheffield, UK.
D RevillNorth Trent Cancer Research Network Consumer Research Panel, Sheffield, UK.
J GathNorth Trent Cancer Research Network Consumer Research Panel, Sheffield, UK.
K HorganDepartment of Breast Surgery, Bexley Cancer Centre, St James's University Hospital, Leeds, UK.
C HolcombeDepartment of Breast Surgery, Liverpool University Hospitals Foundation Trust, Liverpool, UK.
M C WinterSheffield Teaching Hospitals NHS Foundation Trust, Weston Park Hospital, Sheffield, UK.
J NaikDepartment of General Surgery, Pinderfields Hospital, Mid Yorkshire NHS Foundation Trust, Wakefield, UK.
R ParmeschwarDepartment of Breast Surgery, University Hospitals of Morecambe Bay, Lancaster, UK.
L WyldDepartment of Oncology and Metabolism, University of Sheffield Medical School, Sheffield, UK.ORCID 0000-0002-4046-5940
University of Sheffield · GBBrighton and Sussex Medical School · GBNIHR Research Delivery Network · GBCardiff University · GBWeston Park Cancer Centre · GBBaylor College of Medicine · USMid Yorkshire Hospitals NHS Trust · GBRoyal Marsden Hospital · GBSahlgrenska University Hospital · SESheffield Hallam University · GBSt James's University Hospital · GBUniversity Hospitals of Morecambe Bay NHS Foundation Trust · GBUniversity of Leicester · GBUniversity of Nottingham · GBUniversity of Reading · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPrimary endocrine therapy may be an alternative treatment for less fit women with oestrogen receptor (ER)-positive breast cancer. This study compared quality-of-life (QoL) outcomes in older women treated with surgery or primary endocrine therapy.

methodsThis was a multicentre, prospective, observational cohort study of surgery or primary endocrine therapy in women aged over 70 years with operable breast cancer. QoL was assessed using European Organisation for Research and Treatment of cancer QoL questionnaires QLQ-C30, -BR23, and -ELD14, and the EuroQol Five Dimensions 5L score at baseline, 6 weeks, and 6, 12, 18, and 24 months. Propensity score matching was used to adjust for baseline variation in health, fitness, and tumour stage.

resultsThe study recruited 3416 women (median age 77 (range 69-102) years) from 56 breast units. Of these, 2979 (87.2 per cent) had ER-positive breast cancer; 2354 women had surgery and 500 received primary endocrine therapy (125 were excluded from analysis due to inadequate data or non-standard therapy). Median follow-up was 52 months. The primary endocrine therapy group was older and less fit. Baseline QoL differed between the groups; the mean(s.d.) QLQ-C30 global health status score was 66.2(21.1) in patients who received primary endocrine therapy versus 77.1(17.8) among those who had surgery plus endocrine therapy. In the unmatched analysis, changes in QoL between 6 weeks and baseline were noted in several domains, but by 24 months most scores had returned to baseline levels. In the matched analysis, major surgery (mastectomy or axillary clearance) had a more pronounced adverse impact than primary endocrine therapy in several domains.

conclusionAdverse effects on QoL are seen in the first few months after surgery, but by 24 months these have largely resolved. Women considering surgery should be informed of these effects.

Indexed as

Quality of LifeAgedAged, 80 and overAntineoplastic Agents, HormonalBreast NeoplasmsFemaleHumansLongitudinal StudiesMastectomyProspective StudiesReceptors, EstrogenAntineoplastic Agents, HormonalReceptors, Estrogen

Identifiers

PMID33760065
PMCPMC10364859
OpenAlexW3136341943

What OpenQuestion holds

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LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.