Operation with less adjuvant therapy for elderly breast cancer

Area of Science:

• Oncology
• Geriatric Medicine
• Surgical Oncology

Background:

• The optimal management for elderly women diagnosed with breast cancer is a subject of ongoing debate.
• This study addresses the controversial standard of care for this demographic.

Purpose of the Study:

• To investigate and clarify the surgical management strategies employed for elderly breast cancer patients.
• To analyze treatment patterns and survival outcomes across different age groups.

Main Methods:

• A retrospective cohort study involving 2276 breast cancer patients who underwent surgery from 1993 to 2014.
• Patients were stratified into three age groups: young (≤64 years), older (65-74 years), and elderly (≥75 years).

Main Results:

• Elderly patients presented with more advanced stage disease at diagnosis and were more likely to undergo mastectomy.
• The elderly group showed a higher omission rate for axillary operations and radiotherapy post-breast-conserving surgery.
• Despite receiving less chemotherapy, survival rates (distant metastasis-free and breast cancer-specific) were comparable across all age groups, though locoregional recurrence was higher in the elderly.

Conclusions:

• Advanced stage at diagnosis and reduced treatment intensity in elderly breast cancer patients did not negatively impact overall survival.
• Consideration of omitting axillary dissection, radiation, and chemotherapy in surgical breast cancer patients aged 75 and above warrants further investigation.