Treatment Strategies in Elderly Patients With Operable, Hormone Receptor-negative Breast Cancer

Elderly patients with early-stage breast cancer have potentially been underrepresented in clinical trials. Thus, treatment strategies for a minority of elderly patients with hormone receptor (HR)-negative breast cancer may be inadequately informed.

We retrospectively reviewed 126 patients with HR-negative breast cancer aged ≥65 years. Patients aged ≥75 years (group A) were compared with those aged 65-74 years (group B). Of the 126 surgically treated patients, 48 were in group A and 78 were in group B.

The number of patients who did not undergo axillary lymph node surgery was significantly higher in group A than that in group B (15% vs. 2%, respectively, p=0.047). The number of patients who received radiotherapy was significantly lower in group A than B (13% vs. 44%, respectively, p<0.01). The number of patients who did not receive chemotherapy was significantly higher in group A than B (79% vs. 23%, respectively, p<0.01). Breast cancer-specific survival and overall survival showed no significant difference between groups.

Omission of axillary surgery, radiation, or chemotherapy may not have a significant prognostic impact in patients with HR-negative breast cancer aged ≥75 years. Multiple age-related factors complicate the standardization of optimal treatment decisions for these patients.