Abstract
Introduction: The numbers of elderly patients with breast cancers are increasing with an ageing population, yet clinical research on these patients is still lacking. This study aims to examine the differences between elderly patients and their younger counterparts, with a view to optimize management plans for the former. Methods: Patients ≥ 40 years old with histologically proven breast cancer between 1991 and 2008 were identified from our database, and grouped according to age for analyses: old elderly (≥75 years), young elderly (65 to 74 years) and young (40 to 64 years). Clinicopathologic characteristics, treatment and survival rates were compared across the 3 groups. Results: There were 103 (11.53%) old elderly, 147 (16.5%) young elderly and 643 (72.0%) young patients. The 2 elderly groups presented at later stages, received less adjuvant or palliative chemotherapy (P < 0.001), and less adjuvant radiotherapy (P < 0.001), compared to the younger patients. Both breast cancer specific survival (CSS) and overall survival (OS) in the old elderly (CSS: 64.7% (95% confidence interval [CI]: 53.4% - 73.8%), OS: 46.4% (95% CI: 35.6% - 56.4%)) and young elderly group (CSS: 82.4% (95% CI: 74.4% - 88.0%) OS: 78.6% (95% CI: 70.4% - 84.8%)) were lower than the young patient group (CSS: 84.9% (95% CI: 81.6% - 87.7%), OS: 83.4% (95% CI: 80.0% - 86.3%)) at 5 years. Conclusion: Our findings showed that clinicopathologic characteristics of elderly breast cancer patients differed from their younger counterparts. Poorer survival outcomes among our elderly patients may be the result of their under-treatment.
Highlights
The numbers of elderly patients with breast cancers are increasing with an ageing population, yet clinical research on these patients is still lacking
Median follow-up was 5.9 years.There were 103 (11.53%), 147 (16.5%) and 643 (72.0%) old elderly, young elderly and young patients respectively, with the racial distribution being similar to our national demographics [17]
The patients over 65 years of age had significantly more co-morbidities than the young patients (66.7% vs. 33.3% with P = 0.0003), there were no significant differences in co-morbidities between the young elderly and the old elderly groups (33.3% vs. 66.7% with P = 0.1298)
Summary
The numbers of elderly patients with breast cancers are increasing with an ageing population, yet clinical research on these patients is still lacking. The 2 elderly groups presented at later stages, received less adjuvant or palliative chemotherapy (P < 0.001), and less adjuvant radiotherapy (P < 0.001), compared to the younger patients. Both breast cancer specific survival (CSS) and overall survival (OS) in the old elderly (CSS: 64.7% (95% confidence interval [CI]: 53.4% - 73.8%), OS: 46.4% (95% CI: 35.6% - 56.4%)) and young elderly group (CSS: 82.4% (95% CI: 74.4% - 88.0%) OS: 78.6% (95% CI: 70.4% - 84.8%)) were lower than the young patient group (CSS: 84.9% (95% CI: 81.6% - 87.7%), OS: 83.4% (95% CI: 80.0% - 86.3%)) at 5 years. Heterogeneity in the aging process adds to the difficulties of defining this age limit [7]
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