Clinicopathologic Features and Long-Term Outcomes of Elderly Breast Cancer Patients: Experiences at a Single Institution in Korea

Abstract

PurposeThe purpose of this study was to assess the tumor characteristics and long-term clinical outcomes of adjuvant treatments after surgery with a curative aim for patients with breast cancer who are 65 years and older.Materials and MethodsPatients with breast cancer who underwent curative surgery from 2000 to 2009 were analyzed (n=4,388). Tumor characteristics and survival outcome were compared by dividing the patients into two age groups (< 65 and ≥ 65 years old). The Kaplan-Meier method was used for comparison of survival rates by log-rank test, and a Cox regression model was used to examine the effect of variables.ResultsAmong 4,388 patients with invasive breast cancer, 317 patients (7.2%) were 65 years or older and the median age of all patients was 47 years (range, 18 to 91 years). Tumor characteristics were similar between the two age groups, but the older patients were treated less often with adjuvant treatments. During a median follow-up period of 122 months, recurrence-free survival (RFS) was equivalent for patients 65 years and older compared to younger patients, but significantly worse in overall survival (OS) and breast cancer–specific survival (BCSS) (5-year OS, 94.3% vs. 90.5%; p < 0.001 and 5-year BCSS, 94.7% vs. 91.8%; p=0.031). In the multivariate model, age ≥ 65 years old was identified as an independent risk factor for OS and RFS.ConclusionElderly breast cancer appeared to have worse outcomes with very low prevalence in Korea, despite similar tumor characteristics. More active adjuvant therapies would have a role for aggressive subtypes for fit, elderly patients.

Observational study of coagulation activation in early breast cancer: development of a prognostic model based on data from the real world setting

“…Among the clinically relevant patient- and disease-related determinants of interest, age and tumour size (pT) showed prognostic relevance in uni- and multi-variate analysis and were thus included in the model for risk stratification. This evidence is consistent with previous literature from the early setting [ 20 , 21 ]. In strict regard to the patient age, our results provide several hints for discussion.…”

Survival outcomes in elderly Taiwanese women according to breast cancer subtype and lymph node status: A single-center retrospective study

“…Previous studies have indicated that advanced age is associated with more favorable tumor biology and that breast cancer-related survival in elderly women is similar to that in the general population, regardless of disease status [ 17 ]. For example, Kim et al [ 18 ] compared 4388 patients with invasive breast cancer according to age (<65 and ≥65 years) and reported a median age of 47 years (range: 18–91 years) and 317 patients (7.2%) who were ≥65 years old. Their results indicated that the tumor characteristics were similar between the two age groups.…”

Do site and type of metastasis in breast cancer show a changing pattern with increased age? A cross comparison of clinicopathological characteristics between age groups

“…Similarly, they found a higher rate of BCS in their younger population (83 vs. 66%; p < 0.001); they also found lower rates of chemotherapy (4 vs. 31%; p < 0.001) and radiotherapy (44 vs. 67%; p < 0.001) among older patients. Other studies have also evaluated elderly patients, in a retrospective cohort of 317 patients from South Korea [ 17 ]; authors did not find any difference between age groups of older than 65 years old and younger than 65 years old regarding stage, nuclear grade and histological grade. However, they did find those younger than 65 years old to have higher rates of lymphovascular invasion, adjuvant chemotherapy, radiotherapy, and endocrine therapy.…”