Breast cancer in elderly patients over 70 years of age

Abstract

Introduction: Breast carcinoma is the most frequent cancer in women. One third of breast cancer patients are older than 70 years and this proportion
of senior patients is going to increase. Therapy must be multidisciplinary, combining the principles of cancer treatment with therapy of
aging-associated diseases.
Method: Our retrospective study assessed surgical and adjuvant therapy in female patients with breast carcinoma aged 70 years and older operated
on from 1 January 2013 to 1 January 2016 at the Atlas Hospital in Zlin. 637 surgical procedures for breast carcinoma were carried out in the above
period, and 239 of these patients were 70 years old or older. This subgroup represents 37.5% of all women undergoing breast surgery. A total of 66
patients (10.4%) were 80 or older.
Results: Patients were divided into two subgroups: 70−79 years of age and 80 years of age or older. In the 70–79 subgroup, 123 (71%) breast saving
surgeries, 113 (64.5%) sentinel lymph node biopsies (SLNB) and 49 (18%) axillary dissections were performed. In adjuvant therapy, a combination
of radiotherapy and hormonal therapy dominated (83×) and hormonal therapy alone was administered 20×. Combinations with chemotherapy
and targeted treatment were used in a minority of the cases. In the subgroup of patients older than 80 years, more mastectomies (32, accounting
for 48.5%) were performed. SLNB was performed 30x (45.5%) and axillary dissection 30x (45.5%). Hormonal therapy (31x) and radiotherapy in
combination with hormonal therapy (19x) were most frequently used as adjuvant therapy.
Conclusions: Our results suggest a clear trend towards more common hormonal treatment, less chemotherapy and radiotherapy indications and
more frequent mastectomy among patients aged 80 or older.