Tumor characteristics and treatment of breast cancer in elderly patients

Introduction: Elderly patients are underrepresented in breast cancer research. The aim of our study was to analyze tumor characteristics and differences in treatment of patients ≥75y with breast cancer (BC).

Material and methods: Retrospective analysis of data from patients with BC treated at the university hospital of Berne between 2013 and 2015. Women ≥75y were compared to postmenopausal patients 50 – 74y.

Statistical analysis was performed with GraphPad Prism 5.

Results: In our cohort 47 (14.8%) patients were ≥75y (75 – 94) old and compared to 137 patients in the control group. The older patients presented with locally more advanced stage (T3/4) at diagnosis (29.7% vs. 8%, p < 0.001) and were more often treated by mastectomy (53.2% vs. 24.1%, p < 0.001). In contrast we didn't find significant differences in histology, grading, receptor status, proliferation rate and molecular subtypes. When radiotherapy was administered elderly women were more likely to receive partial breast irradiation (41.9% vs. 17.3%, p < 0.001). Only few old women received chemotherapy; 9.3% vs. 25.4% in the control group (p 0.03).

In 12 (31.6%) of the elderly women treatment differed from the tumor board recommendations compared to 11 (11.6%) in the control group (p 0.01). Due to comorbidities or patients request chemotherapy was omitted in 8 cases and radiotherapy in 5 women.

Conclusion: In 31.6% of our elderly patients with BC tumor board recommendations were not followed into practice. According to the literature we found that old patients seem to be undertreated in terms of adjuvant therapy.