{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T22:50:45Z","timestamp":1789685445844,"version":"4.0.1"},"reference-count":49,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:00:00Z","timestamp":1756339200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Fondazione Prometeus, ONLUS"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Background: Breast cancer is frequently diagnosed in older women. However, the impact of surgery on survival is not well studied and prognosis for women \u2265 80 years of age is progressively depending on comorbidities. Methods: Medical records of consecutive women aged \u2265 80 years diagnosed with primary breast cancer treated with upfront surgery at two Breast Centers from 2011 to 2021 were retrospectively analyzed. Results: A total of 553 consecutive women with a median age of 83 years and a median tumor diameter of 21 mm were analyzed (574 lesions). Clinical Stages II or III were found in 263\/574 (46%) and 101\/574 cases (18%), respectively. Axillary staging was completely omitted for 94\/542 invasive lesions (17%), and this increased over time from 2% to 33% (p &lt; 0.001). Adjuvant hormone therapy and radiotherapy were omitted in 134\/490 (27%) and in 122\/420 patients (29%), respectively, while only 26\/195 (13%) of patients with a clear clinical indication received adjuvant chemotherapy. At a median follow-up of 61 months (6\u2013147) the 5- and 10-years overall survival (OS) were 64% and 21%, while breast cancer-specific survival (BCSS) at 5 and 10 years were 94% and 78%, respectively. Adjuvant therapies were not associated with a significant improvement in BCSS, while worse OS was associated with older age or more comorbidities as measured by the Charlson Comorbidity Index (CCI) (p &lt; 0.001 and p = 0.012, respectively). Conclusions: Breast surgery, when possible, has a primary role even for women &gt; 80 years of age, and it is associated with a reasonable BCSS. De-escalation of adjuvant therapies should be considered in this setting because survival is largely determined by age and co-morbidities.<\/jats:p>","DOI":"10.3390\/curroncol32090482","type":"journal-article","created":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T15:03:14Z","timestamp":1756393394000},"page":"482","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["De-Escalation of Treatment in Women Aged \u226580 Years with Breast Cancer: A Retrospective Analysis from Two Breast Centers"],"prefix":"10.3390","volume":"32","author":[{"given":"Gianmarco","family":"Piccolino","sequence":"first","affiliation":[{"name":"Breast Center, Department of Surgery, San Giovanni-Addolorata Hospital, 00184 Rome, Italy"},{"name":"Department of Surgical Science, University of Rome \u201cLa Sapienza\u201d, Sant\u2019 Andrea Hospital, 00189 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Cardelli","sequence":"additional","affiliation":[{"name":"Department of Surgical Science, University of Rome, \u201cTor Vergata\u201d Hospital, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Arienzo","sequence":"additional","affiliation":[{"name":"Pathology Unit, San Giovanni-Addolorata Hospital, 00184 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuele","family":"Zarba Meli","sequence":"additional","affiliation":[{"name":"Breast Center, Department of Surgery, San Giovanni-Addolorata Hospital, 00184 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Del Giudice","sequence":"additional","affiliation":[{"name":"Geriatric Unit, San Giovanni-Addolorata Hospital, 00184 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9545-8123","authenticated-orcid":false,"given":"Leopoldo","family":"Costarelli","sequence":"additional","affiliation":[{"name":"Pathology Unit, San Giovanni-Addolorata Hospital, 00184 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosalinda","family":"Rossi","sequence":"additional","affiliation":[{"name":"Department of Oncology, San Giovanni-Addolorata Hospital, 00184 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Scaringi","sequence":"additional","affiliation":[{"name":"Radiotherapy Unit, San Giovanni-Addolorata Hospital, 00184 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiziana","family":"Mastropietro","sequence":"additional","affiliation":[{"name":"Breast Center, Department of Surgery, San Giovanni-Addolorata Hospital, 00184 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Broglia","sequence":"additional","affiliation":[{"name":"Breast Radiology, San Giovanni-Addolorata Hospital, 00184 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Vitale","sequence":"additional","affiliation":[{"name":"Department of Surgical Science, University of Rome \u201cLa Sapienza\u201d, Sant\u2019 Andrea Hospital, 00189 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Bergamo","sequence":"additional","affiliation":[{"name":"Department of Surgical Science, University of Rome \u201cLa Sapienza\u201d, Sant\u2019 Andrea Hospital, 00189 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Manna","sequence":"additional","affiliation":[{"name":"Breast Center, Department of Surgery, San Giovanni-Addolorata Hospital, 00184 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"La Pinta","sequence":"additional","affiliation":[{"name":"Breast Center, Department of Surgery, San Giovanni-Addolorata Hospital, 00184 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Palleschi","sequence":"additional","affiliation":[{"name":"Geriatric Unit, San Giovanni-Addolorata Hospital, 00184 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7378-8431","authenticated-orcid":false,"given":"Andrea","family":"Loreti","sequence":"additional","affiliation":[{"name":"Breast Center, Department of Surgery, San Giovanni-Addolorata Hospital, 00184 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4520-0183","authenticated-orcid":false,"given":"Augusto","family":"Lombardi","sequence":"additional","affiliation":[{"name":"Department of Surgical Science, University of Rome \u201cLa Sapienza\u201d, Sant\u2019 Andrea Hospital, 00189 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucio","family":"Fortunato","sequence":"additional","affiliation":[{"name":"Breast Center, Department of Surgery, San Giovanni-Addolorata Hospital, 00184 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,28]]},"reference":[{"key":"ref_1","first-page":"438","article-title":"Breast cancer statistics, 2019","volume":"69","author":"DeSantis","year":"2019","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","unstructured":"United Nations, Department of Economic and Social Affairs, Population Division (2020). World Population Ageing 2019, United Nations. Available online: https:\/\/www.un.org\/en\/development\/desa\/population\/publications\/pdf\/ageing\/WorldPopulationAgeing2019-Report.pdf."},{"key":"ref_3","unstructured":"Ries, L.A., Eisner, M.P., Kosary, C.L., Hankey, B.F., Miller, B.A., Clegg, L., Mariotto, A., Fay, M.P., Feuer, E.J., and Edwards, B.K. (2009). SEER Cancer Statistics Review 1973\u20131999, National Cancer Institute."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1769","DOI":"10.1001\/jamaoncol.2019.2055","article-title":"Factors Associated With Age Disparities Among Cancer Clinical Trial Participants","volume":"5","author":"Ludmir","year":"2019","journal-title":"JAMA Oncol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"S57","DOI":"10.1016\/S0960-9776(19)31125-7","article-title":"Impact of older age on local treatment decisionss","volume":"48","author":"Ugurlu","year":"2019","journal-title":"Breast"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"893104","DOI":"10.1155\/2013\/893104","article-title":"Undertreated breast cancer in the elderly","volume":"2013","author":"Malik","year":"2013","journal-title":"J. Cancer Epidemiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1001\/jamasurg.2015.0647","article-title":"Not Performing a Sentinel Node Biopsy for Older Patients With Early-Stage Invasive Breast Cancer","volume":"150","author":"Chung","year":"2015","journal-title":"JAMA Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1016\/j.jgo.2018.10.007","article-title":"The role of Geriatric screening tool (G8) in predicting side effect in older patients during therapy with aromatase inhibitor","volume":"10","author":"Dottorini","year":"2019","journal-title":"J. Geriatr. Oncol."},{"key":"ref_9","first-page":"CD004272","article-title":"Surgery versus primary endocrine therapy for operable primary breast cancer in elderly women (70 years plus)","volume":"1","author":"Hind","year":"2006","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1016\/j.ejso.2014.02.224","article-title":"Primary endocrine therapy as a treatment for older women with operable breast cancer\u2014A comparison of randomised controlled trial and cohort study findings","volume":"40","author":"Morgan","year":"2014","journal-title":"Eur. J. Surg. Oncol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1393","DOI":"10.1038\/bjc.2011.105","article-title":"Long-term clinical outcome of oestrogen receptor-positive operable primary breast cancer in older women: A large series from a single centre","volume":"104","author":"Syed","year":"2011","journal-title":"Br. J. Cancer"},{"key":"ref_12","unstructured":"Society of Surgical Oncology (2025, August 25). Choosing Wisely: An Initiative of the ABIM Foundation. 12 July 2016. Available online: http:\/\/www.choosingwisely.org\/societies\/society-of-surgical-oncology\/."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/01.sla.0000167759.15670.14","article-title":"A randomized trial comparing axillary dissection to no axillary dissection in older patients with T1N0 breast cancer: Results after 5 years of follow-up","volume":"242","author":"Martelli","year":"2005","journal-title":"Ann. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"International Breast Cancer Study Group, Rudenstam, C.M., Zahrieh, D., Forbes, J.F., Crivellari, D., Holmberg, S.B., Rey, P., Dent, D., Campbell, I., and Bernhard, J. (2006). Randomized trial comparing axillary clearance versus no axillary clearance in older patients with breast cancer: First results of International Breast Cancer Study Group Trial 10-93. J. Clin. Oncol., 24, 337\u2013344.","DOI":"10.1200\/JCO.2005.01.5784"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2382","DOI":"10.1200\/JCO.2012.45.2615","article-title":"Lumpectomy plus tamoxifen with or without irradiation in women age 70 years or older with early breast cancer: Long-term follow-up of CALGB 9343","volume":"31","author":"Hughes","year":"2013","journal-title":"J. Clin. Oncol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1557","DOI":"10.1001\/jamaoncol.2023.3759","article-title":"Sentinel Lymph Node Biopsy vs No Axillary Surgery in Patients With Small Breast Cancer and Negative Results on Ultrasonography of Axillary Lymph Nodes: The SOUND Randomized Clinical Trial","volume":"9","author":"Gentilini","year":"2023","journal-title":"JAMA Oncol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1056\/NEJMoa2412063","article-title":"Axillary Surgery in Breast Cancer\u2014Primary Results of the INSEMA Trial","volume":"392","author":"Reimer","year":"2025","journal-title":"N. Engl. J. Med."},{"key":"ref_18","unstructured":"National Institute for Health and Care Excellence (2020, November 27). Early and Locally Advanced Breast Cancer: Diagnosis and Management. 18 July 2018. Available online: https:\/\/www.nice.org.uk\/guidance\/ng101."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"433","DOI":"10.6004\/jnccn.2017.0044","article-title":"NCCN Guidelines Insights: Breast Cancer, Version 1.2017","volume":"15","author":"Gradishar","year":"2017","journal-title":"J. Natl. Compr. Cancer Netw."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.breast.2020.02.003","article-title":"The requirements of a specialist breast centre","volume":"51","author":"Biganzoli","year":"2020","journal-title":"Breast"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1783","DOI":"10.1245\/s10434-018-6486-6","article-title":"Eighth Edition of the AJCC Cancer Staging Manual: Breast Cancer","volume":"25","author":"Giuliano","year":"2018","journal-title":"Ann. Surg. Oncol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1200\/EDBK_201313","article-title":"New and important changes in the TNM Staging System for breast cancer","volume":"38","author":"Hortobagyi","year":"2018","journal-title":"Am. Soc. Clin. Oncol. Educ. Book"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"5158","DOI":"10.1158\/1078-0432.CCR-07-4756","article-title":"Biological processes associated with breast cancer clinical outcome depend on the molecular subtypes","volume":"14","author":"Desmedt","year":"2008","journal-title":"Clin. Cancer Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1016\/0895-4356(92)90133-8","article-title":"Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases","volume":"45","author":"Deyo","year":"1992","journal-title":"J. Clin. Epidemiol."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Limpawattana, P., and Manjavong, M. (2021). The Mini-Cog, Clock Drawing Test, and Three-Item Recall Test: Rapid Cognitive Screening Tools with Comparable Performance in Detecting Mild NCD in Older Patients. Geriatrics, 6.","DOI":"10.3390\/geriatrics6030091"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1646","DOI":"10.1016\/j.jamda.2020.09.038","article-title":"The Short Physical Performance Battery (SPPB): A Quick and Useful Tool for Fall Risk Stratification Among Older Primary Care Patients","volume":"22","author":"Welch","year":"2021","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1111\/j.1524-4741.2007.00444.x","article-title":"Surgery is associated with lower morbidity and longer survival in elderly breast cancer patients over 80","volume":"13","author":"Rao","year":"2007","journal-title":"Breast J."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"7394","DOI":"10.1245\/s10434-024-16086-y","article-title":"ASO Visual Abstract: Surgery Plays a Leading Role in Breast Cancer Treatment for Patients Aged \u2265 90 Years: A Large Retrospective Cohort Study","volume":"31","author":"Ferrucci","year":"2024","journal-title":"Ann. Surg. Oncol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.ejca.2020.10.015","article-title":"Bridging the age gap in breast cancer. Impacts of omission of breast cancer surgery in older women with oestrogen receptor positive early breast cancer. A risk stratified analysis of survival outcomes and quality of life","volume":"142","author":"Wyld","year":"2021","journal-title":"Eur. J. Cancer"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"5950","DOI":"10.1245\/s10434-021-09839-6","article-title":"Sentinel Node Biopsy Should Not be Routine in Older Patients with ER-Positive HER2-Negative Breast Cancer Who Are Willing and Able to Take Hormone Therapy","volume":"28","author":"McKevitt","year":"2021","journal-title":"Ann. Surg. Oncol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.clbc.2021.07.005","article-title":"Invasive Breast Cancer Treatment Patterns in Women Age 80 and Over: A Report from the National Cancer Database","volume":"22","author":"Frebault","year":"2022","journal-title":"Clin. Breast Cancer"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e216322","DOI":"10.1001\/jamanetworkopen.2021.6322","article-title":"Outcomes After Sentinel Lymph Node Biopsy and Radiotherapy in Older Women With Early-Stage, Estrogen Receptor-Positive Breast Cancer","volume":"4","author":"Carleton","year":"2021","journal-title":"JAMA Netw. Open"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1002\/jso.21799","article-title":"Breast cancer in elderly women (\u2265 80 years): Variation in standard of care?","volume":"103","author":"Cyr","year":"2011","journal-title":"J. Surg. Oncol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1016\/j.ijsu.2013.05.032","article-title":"Surgery improves breast cancer-specific survival in octogenarians with early-stage breast cancer","volume":"11","author":"Cortadellas","year":"2013","journal-title":"Int. J. Surg."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Besic, N., Besic, H., Peric, B., Pilko, G., Petric, R., Zmuc, J., Dzodic, R., and Perhavec, A. (2014). Surgical treatment of breast cancer in patients aged 80\u2009years or older--how much is enough?. BMC Cancer, 14.","DOI":"10.1186\/1471-2407-14-700"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1016\/j.ejso.2019.01.019","article-title":"Surgical treatment and prognosis of breast cancer in elderly\u2014A population-based study","volume":"45","author":"Ojala","year":"2019","journal-title":"Eur. J. Surg. Oncol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1016\/j.ejso.2020.10.008","article-title":"Breast cancer in the oldest old (\u2265 89 years): Tumor characteristics, treatment choices, clinical outcomes and literature review","volume":"47","author":"Tognazzo","year":"2021","journal-title":"Eur. J. Surg. Oncol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1145","DOI":"10.1002\/bjs.11568","article-title":"Effect of omission of surgery on survival in patients aged 80\u2009years and older with early-stage hormone receptor-positive breast cancer","volume":"107","author":"Dekkers","year":"2020","journal-title":"Br. J. Surg."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/j.breast.2021.07.005","article-title":"Higher-risk breast cancer in women aged 80 and older: Exploring the effect of treatment on survival","volume":"59","author":"Xu","year":"2021","journal-title":"Breast"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"917","DOI":"10.1016\/j.jgo.2020.02.005","article-title":"The challenge of avoiding over- and under-treatment in older women with ductal cancer in situ: A scoping review of existing knowledge gaps and a meta-analysis of real-world practice patterns","volume":"11","author":"Karakatsanis","year":"2020","journal-title":"J. Geriatr. Oncol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e327","DOI":"10.1016\/S1470-2045(20)30741-5","article-title":"Updated recommendations regarding the management of older patients with breast cancer: A joint paper from the European Society of Breast Cancer Specialists (EUSOMA) and the International Society of Geriatric Oncology (SIOG)","volume":"22","author":"Biganzoli","year":"2021","journal-title":"Lancet Oncol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1016\/S1470-2045(14)71221-5","article-title":"Breast-conserving surgery with or without irradiation in women aged 65 years or older with early breast cancer (PRIME II): A randomised controlled trial","volume":"16","author":"Kunkler","year":"2015","journal-title":"Lancet Oncol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1186\/s13014-017-0796-x","article-title":"The benefit of adjuvant radiotherapy after breast conserving surgery in older patients with low risk breast cancer- a meta-analysis of randomized trials","volume":"12","author":"Matuschek","year":"2017","journal-title":"Radiat. Oncol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1245\/s10434-018-07151-4","article-title":"Radiation Therapy After Breast-Conserving Surgery in Women 70 Years of Age and Older: How Wisely Do We Choose?","volume":"26","author":"Zabor","year":"2019","journal-title":"Ann. Surg. Oncol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1016\/j.jss.2020.07.023","article-title":"Long-term impact of CALGB 9343 on radiation utilization","volume":"256","author":"Squeo","year":"2020","journal-title":"J. Surg. Res."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1007\/s10549-019-05356-z","article-title":"Improved survival of older patients with advanced breast cancer due to an increase in systemic treatments: A population-based study","volume":"178","author":"Bastiaannet","year":"2019","journal-title":"Breast Cancer Res. Treat."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1076","DOI":"10.1634\/theoncologist.2014-0184","article-title":"Age-specific changes in intrinsic breast cancer subtypes: A focus on older women","volume":"19","author":"Jenkins","year":"2014","journal-title":"Oncologist"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Peng, Y., Hu, T., Cheng, L., Tong, F., Cao, Y., Liu, P., Zhou, B., Liu, M., Liu, H., and Guo, J. (2021). Evaluating and Balancing the Risk of Breast Cancer-Specific Death and Other Cause-Specific Death in Elderly Breast Cancer Patients. Front. Oncol., 11.","DOI":"10.3389\/fonc.2021.578880"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/j.jgo.2020.07.013","article-title":"Exclusive endocrine therapy or partial breast irradiation for women aged \u226570 years with luminal A-like early stage breast cancer (NCT04134598\u2014EUROPA): Proof of concept of a randomized controlled trial comparing health related quality of life by patient reported outcome measures","volume":"12","author":"Meattini","year":"2021","journal-title":"J. Geriatr. Oncol."}],"container-title":["Current Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1718-7729\/32\/9\/482\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:34:47Z","timestamp":1760034887000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1718-7729\/32\/9\/482"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,28]]},"references-count":49,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["curroncol32090482"],"URL":"https:\/\/doi.org\/10.3390\/curroncol32090482","relation":{},"ISSN":["1718-7729"],"issn-type":[{"value":"1718-7729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,28]]}}}