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Breast cancer in the elderly

S E Singletary1, R Shallenberger, V F Guinee

  • 1Department of General Surgery, University of Texas M. D. Anderson Cancer Center, Houston 77030.

Annals of Surgery
|November 1, 1993
PubMed
Summary
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Elderly women with breast cancer tolerate treatment well, achieving a 7-year survival rate of 79%. However, screening and treatment underutilization were noted, highlighting the need for age-appropriate care decisions.

Area of Science:

  • Oncology
  • Geriatric Medicine
  • Clinical Breast Cancer Research

Background:

  • Breast cancer incidence increases with age.
  • Limited data exists on the clinical behavior and outcomes of breast cancer in elderly populations.
  • Optimal treatment strategies for older adults require further investigation.

Purpose of the Study:

  • To evaluate the clinical behavior and treatment outcomes of breast cancer in women aged 69 years and older.
  • To assess survival rates and treatment modalities in elderly breast cancer patients.
  • To identify potential disparities in screening and treatment for older women.

Main Methods:

  • Retrospective study of 184 women aged over 69 years treated for locoregional breast cancer.
  • Data collected from The University of Texas M. D. Anderson Cancer Center between 1976 and 1985.

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  • Median follow-up of 80 months to assess outcomes.

    • Main Results:

    • Elderly women tolerated standard surgical therapy well, with a 7-year breast cancer-specific survival rate of 79%.
    • Despite a significant proportion of early-stage disease (33%), breast conservation surgery was infrequent (10%).
    • Adjuvant systemic therapy was underutilized (fewer than 13%), and screening compliance was low (3% detected by mammograms, 12% by physical exams).

    Conclusions:

    • Elderly women can achieve favorable outcomes with standard breast cancer treatments.
    • Treatment decisions should prioritize physiologic status over chronological age.
    • Improved adherence to screening guidelines and utilization of appropriate therapies are crucial for older women with breast cancer.