Abstract
<i>Context:</i> The prognosis and treatment outcome in elderly breast cancer is not well known. <i>Aim:</i> To study the prognosis and treatment outcome in elderly breast cancer. <i>Methods and materials:</i> This a retrospective study of breast cancer patients’ ≥70years in the period from January 2005 until December 2010 in Egypt. Kaplan Meir overall survival (OS) analysis and disease-free survival (DFS) were done and they were correlated with different prognostic factors. <i>Results:</i> Among 186 old patients, 139 one were analyzed. The median age was 73.4 years at diagnosis with a mean of 75. Most patients (70.4%) were in the range of 70-74 from urban areas (89.2%) with performance status 1-2 (90.6%) and with ≤ 2 co-morbidity (67.6%). Stage III and IV presented 43.9%. Positive ER and PR was 83.4% and 75.5% respectively. Surgery was done in 77.7% of cases with 62.6% modified radical mastectomy and 15.1% conservative lumpectomy and axillary clearance. Treatment included mostly hormonal treatment (79.9%), radiotherapy (47.5%) and lastly chemotherapy (18.7%). The 5-year OS and DFS were 52% and 53.4% respectively. The median progression free survival (PFS) in metastatic patients was 4 months. The DFS was significantly affected by performance status (PS), tumor stage, and presence of metastasis. (P-value = 0.018, <0.001, 0.003 respectively). <i>Conclusion:</i> the 5-year OS was lower than the developed country. The majority of deaths (55.7%) were not related to breast cancer. Primary tumor stage and metastasis were significant prognostic factor for DFS.
Highlights
Breast cancer is the most common malignancy in females in Egypt
The management of elderly patients is controversial across the studies with trials showing that less aggressive treatment has no impact on recurrence in patients > 70 as compared to conventional treatment [6]
This study showed the lowest net five-year survival in elderly patients, age 80-99 years regardless of any other cause of mortality related to this age group [13]
Summary
Breast cancer is the most common malignancy in females in Egypt. It accounts for 32 % of cancer in women [1]. A significant increase in breast cancer incidence was evident among women aged 50 years and older, and the highest incidence among women aged 70 years and older [3]. Life expectancy has increased to reach 76 years in female and 70 years in males [4, 5]. The management of elderly patients is controversial across the studies with trials showing that less aggressive treatment has no impact on recurrence in patients > 70 as compared to conventional treatment [6]. Where-as other studies highlight the importance of aggressive treatment in improving DFS and OS in the elderly patients [7]
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