Abstract
Although locally advanced breast cancer (LABC) is more common in the elderly population, there is little data on the clinical characteristics and survival of these patients. The aim of the present study was to compare different factors affecting survival in elderly patients with LABC. Retrospective analysis was carried out on a cohort of 80 patients aged 70 to 96 years, diagnosed with LABC defined as T3 N1, T4 N0, any N2 or N3, and M0. The prognostic impact of selected clinical parameters including age, comorbidities, tumour grade, HER2 status, tumour stage, local therapies, and systemic treatments was studied. The median age of the patients was 79 years. The majority (n=53; 66%) had at least one significant comorbidity according to the Charlson score evaluation. The median overall survival was 50.6 months. As expected, hormonal therapy was the dominant mode of systemic treatment, but 24% also received at least one line of chemotherapy. Local therapies including surgery and/or radiotherapy were applied in 58% of patients. The diagnosis of LABC in the elderly is associated with poor prognosis. Age and serious comorbidities were negative prognostic factors.
Highlights
Breast cancer is the most common cancer in women in developed countries
One of the reasons for the poor outcome is the fact that elderly women with breast cancer present more frequently with locally advanced breast cancer (LABC) without distant metastases at the time of diagnosis clearly seen in epidemiology reports (Table 1)
Specific mortality data for elderly stage III patients are not provided and less than half of deaths in patients ≥ 75 were caused by breast cancer, the overall mortality in patients with stage III disease was eight times higher than that in stage I patients[21]. These reports in agreement with our findings indicate that while non-cancer causes are the dominant cause of mortality in elderly women diagnosed with early-stage breast cancer, cancer becomes more prominent as a cause of death in advanced disease stages
Summary
In the Czech Republic, approximately 35% of breast cancer patients are diagnosed at the age of 70 years or more. Age itself is an adverse prognostic factor for overall survival (OS) in breast cancer[2,3]. Clinical guidelines for breast cancer are in agreement that treatment decisions should not be based on age alone while recognising that overall health status plays an important role in the choice of treatment[4,5]. Locally advanced breast cancer (LABC) is more common in the elderly population, there is little data on the clinical characteristics and survival of these patients. The aim of the present study was to compare different factors affecting survival in elderly patients with LABC. The prognostic impact of selected clinical parameters including age, comorbidities, tumour grade, HER2 status, tumour stage, local therapies, and systemic treatments was studied.
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