9545 Background: Elderly women (≥ 70 years of age) comprise approximately 28% of breast cancer cases diagnosed or treated in teaching hospitals in the United States. Given the expected growth in this population, and recent concern regarding healthcare disparities within cancer care, we conducted a single institution retrospective review of treatment patterns in elderly women with breast cancer. Methods: From 1/1/98 through 12/31/03, 314 women ≥ 70 yo with breast cancer (AJCC stages I-III) were treated at our institution. The Chi-square test for linear trend was used to assess the following factors by age group (70–75, 76–80, >80): tumor size, stage, breast conserving therapy (BCT), radiation (XRT), axillary evaluation (SLNB vs ALND), adjuvant hormonal (HT) and chemotherapy (CT). Five-year overall-survival was estimated by the Kaplan-Meier method, and log rank testing was used to assess differences. Results: Of 314 cases, 55.7% were Stage I, 35.7% Stage II, and 8.6% Stage III. Overall, BCT was performed in 143 patients (46.5%); of these, 65.7% received XRT. 236 pts were hormone receptor positive (HRP) and only 24.6% received HT. SLNB was used only 15.6% vs ALND 60.5%; 23.9% of women did not receive any evaluation. BCT decreased with increasing stage: Stage I 57% and Stage II/III 33%. Tumor size significantly increased with age (p=0.006). Overall, axillary evaluation decreased with increasing age (87%, 82%, 57%; p <0.001), as did CT (18%, 14%, 3%; p=0.001). In Stage I, there were no treatment differences by age group. In Stage II/III, CT (40%, 24%, 2%; p<0.001) and XRT in BCT (75%, 100%, 33%; p=0.016) significantly decreased with increasing age. Five-year survival rates also differed by age group (78.8%, 61.1%, and 48.1%, p <0.001); estimates of median survival were 75 months in the 76–80 age group and 54 months in the >80 age group. Conclusions: We demonstrated among women ≥ 70 yo that tumor size increased with age. BCT, XRT and CT were delivered less frequently with increasing age. The majority of HRP pts did not receive HT, and surgical evaluation of the axilla was most commonly accomplished by ALND rather than SLNB. No significant financial relationships to disclose.