A retrospective study of early stage breast cancer patients diagnosed at age 70 and older has reported that elderly women who are appropriately treated have a similar chance of successful outcomes as younger patients. Appropriate treatment for elderly women with breast cancer is controversial. The study was designed to investigate whether elderly breast cancer patients are under treated because of their age and to evaluate their clinical management in a single institution.
The study included 538 women with early stage operable breast cancer treated during the period 1995 to 1999. The patients were divided into three groups based on age: (1) 288 of the women were aged 70 to 75 years; (2) 156 were aged 75 to 80 years; and (3) 94 were at least 80 years of age. Tumors were more likely to be stage T2 (between 2 cm and 5 cm) than T1 (less than 2 cm) and estrogen receptor negative (ER-/PR-) than estrogen receptor positive (ER+/PR+) in women at least 80 years of age than in women between 70 and 80. Breast cancer-specific survival, distant recurrence-free time period, and local control were estimated.
Surgery was performed in 94.6% of the overall study group, breast-conserving in 72.1% (62% in women over 80) with axillary lymph node dissection in 89.2% (77% in women over 80). Among those who had a lumpectomy, 100% received radiotherapy. Fifty-seven percent of the overall study group received adjuvant endocrine treatments and 3.7% received chemotherapy. No significant differences were found between the three age groups for breast cancer-specific survival (91% for age 70 to 75, 89% for age 75 to 80, and 86% for age 80 and over), distant recurrence-free interval, and local control (>90%) seven years after treatment. The authors conclude that elderly women with operable breast cancer who are completely and correctly treated with realistic treatment options including surgery and adjuvant radiation treatment have a similar chance of successful outcomes as younger patients.