What are the clinicopathological features of elderly early-stage breast cancer patients and is there any difference in patients over 70 years of age?

Abstract

Abstract Aim Although patients over 65 years of age are considered to be elderly patients with breast cancer, the performance status and comorbidity of patients aged 70 and over is not the same as patients aged 65–70 years. The aim of this study was to evaluate the treatment modalities, features of patients and disease in elderly early-stage breast cancer patients. Material and methods Data of 87 patients were examined. Demographic data, disease data (tumor size, lymph node involvement, hormone receptor status, Her-2 status), comorbid diseases, and given treatments were evaluated. The patients were divided into two groups as 65–70 years of age and over 70 years of age. All the collected data was compared. Results There was no difference in hormone receptor status between 2 groups (p > 0,05). Her-2 negativity was found to be significantly higher in patients ≥ 70 years (%61 vs %83, p = 0,024). There was no significant difference between two groups in terms of surgery (p > 0,05). The frequency of chemotherapy and radiotherapy was significantly lower in the older group (%37 vs %17, p = 0,009). OS and DFS were significantly shorter in triple negative disease (69.59 months,p = 0.039 and 53.95 months,p = 0.024 respectively). ER positive subtype has a significantly better DFS (164 vs 47 months, p = 0,037) and OS (170 vs 68 months, p = 0,046). Additionally, PR positive disease has a significantly better DFS (129 vs 84 months, p = 0,028) and OS (190 vs 96 months, p = 0,006). HER2-negative subtype had better OS than HER2-positive subtype (172 vs 91 months, p = 0,016). DFS was significantly shorter in ≥70years patients (161.1 months vs 102.1 months, p = 0.045), however OS was not different among the 2 groups. Adjuvant therapy prolongs DFS in both groups(65–70 years 107,5 vs 129,3 months, >70years 86,2 vs 95,7 months p = 0,034). Conclusion Age is an important and independent risk factor for the treatment of the elderly patients, however patient age alone cannot be decisive. In current study, the pathological features of the tumor and the effects of these features on DFS and OS were similar in young breast cancer patients and patients over 70 years of age. In addition, we found that adjuvant treatment modalities affect OS and DFS positively as in the case of young patients. There is an absolute need for prospective studies involving elderly patients.