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Breast cancer in octogenarians.
Ella Evron1, Hadassah Goldberg, Alexander Kuzmin
1Institute of Oncology, Assaf Harofeh Medical Center, Zerifin, Israel.
Cancer
|March 15, 2006
Summary
Older women with breast cancer lived over 6 years post-diagnosis, with less than standard local treatment (SLT) showing increased axillary failures but not worse survival. The sentinel node technique may address these failures.
Area of Science:
- Oncology
- Geriatric Medicine
- Surgical Oncology
Background:
- Increasing incidence of breast cancer in older populations.
- Lack of specific clinical guidelines for elderly cancer patients.
- Need for data on breast cancer natural history and treatment outcomes in octogenarians.
Purpose of the Study:
- To evaluate the outcomes of localized breast cancer treatment in women aged 80 years and older.
- To compare outcomes between standard local treatment (SLT) and less than SLT.
- To assess the natural course and survival of breast cancer in the elderly.
Main Methods:
- Retrospective chart review of 135 women aged 80+ with localized breast cancer.
- Inclusion of patients treated between 1991 and 2001 in two Israeli tertiary centers.
- Analysis of treatment modalities (SLT vs. less than SLT) and patient outcomes.
Main Results:
- Median age at diagnosis was 83 years; 56% received less than SLT.
- Tumors were predominantly T1-T2 (90%), hormone-sensitive (76%), and infiltrating ductal carcinoma (90 cases).
- At median 70 months follow-up, 13% had recurrence, 25% died; axillary failures occurred only in the less-than-SLT group without impacting overall survival.
Conclusions:
- Breast cancer octogenarians in this cohort survived over 6 years, challenging the notion of more indolent tumors in this age group.
- Less than SLT is a viable option for elderly patients, though it may increase axillary failure rates.
- The sentinel node technique could potentially mitigate increased axillary failure rates in this population.