J Breast Dis.  2020 Jun;8(1):25-36. 10.14449/jbd.2020.8.1.25.

Treatment Patterns and Clinical Outcomes in Elderly Patients with Breast Cancer

• Kang KM
• Kim EK
• Kim H
• Kim JH
• Kim SH
• Suh KJ
• Kim IA
• Chae S
• Kim SW
• Kang E

• KMID: 2504518
• DOI: http://doi.org/10.14449/jbd.2020.8.1.25

Abstract

Purpose
Although the number of elderly patients with breast cancer is increasing as the population ages, their treatment is controversial. We evaluated the prognostic factors associated with survival in elderly breast cancer patients and assessed the impact of comorbidity on prognosis.
Methods
This study included 362 patients (aged ≥65 years) who underwent surgery for breast cancer in our institution between 2003 and 2014. The patients were divided into early-aged (65–74 years) and late-aged (≥75 years) groups. Comorbidity was parametrized using the Charlson comorbidity index (CCI). Kaplan–Meier analysis was used to analyze overall survival (OS) and distant metastasis-free survival (DMFS). Prognostic factors were evaluated by Cox proportional hazards regression.
Results
The surgical method, subtypes, stage, and oncological features were similar between early- and late-aged groups; however, smaller proportions of patients in the late-aged group received chemotherapy (12.9% vs. 45.5%) and endocrine therapy (55.3% vs. 73.3%). In multivariable analysis, the poor prognostic factors associated with DMFS and OS were high CCI, high histologic grade, and advanced stage. Chemotherapy, endocrine therapy, and radiotherapy were not significantly related to DMFS and OS.
Conclusion
In this study, adjuvant treatments did not affect the prognosis of elderly patients with breast cancer. To clarify the effects of adjuvant therapies in these patients, a large-scale retrospective study that considers not only tumor characteristics but also life expectancy is necessary.

Keyword

Aged; Breast neoplasms; Comorbidity; Prognosis