The effect of age on treatment choice and survival in elderly breast cancer patients

Abstract

To investigate the effect of age on treatment choice and survival in patients with breast cancer, data from the cancer registry of the Netherlands Cancer Institute (NKI, Amsterdam, The Netherlands) on 611 women have been analyzed. All patients 55 years and older admitted to the NKI for primary treatment of breast cancer between 1981 and 1986 were selected. For women 75 years and older, physicians were less likely to use treatment of adjuvant radiation therapy after a mastectomy and more often employed primary hormonal therapy only for local stage disease than for younger patients. Life-table analysis showed that disease-specific survival at 7 years for patients 65 through 74 years of age was significantly better (65%) than that of the youngest (55%) and the oldest age group (50%). In multivariate regression analysis (Cox), age older than 74 years was significantly and independently associated with a shorter disease-specific survival as compared with patients younger than 75 years. This difference in survival, however, does not seem to be the result of the difference in treatment between the age groups, but suggests an influence of age-related factors such as comorbid diseases and weak physical condition, which manifest themselves most strongly in the oldest age category and make the older woman more vulnerable to the course of malignant disease.

Pathologic and Clinical Characteristics of Elderly Patients With Breast Cancer: A Retrospective Analysis of a Multicenter Study (Anatolian Society of Medical Oncology)

“…[5][6][7] Although little is known about the pathology and biology of breast cancer in older patients, many clinical trials have shown that women who develop breast cancer at an elderly age have less aggressive disease and decreased risk of recurrence. [8][9][10][11] In contrast, a few studies have demonstrated that in postmenopausal patients with hormone receptor-positive breast cancer, increasing age is associated with higher disease-specific mortality.…”

Comorbidity as a Mediator of Survival Disparity Between Younger and Older Women Diagnosed With Metastatic Breast Cancer

“…7 Several studies showed that younger patients had better survival than older patients, 6 -11 and this difference in survival between age groups does not seem to be the result of the difference of treatment but suggests the influence of age-related factors such as comorbid conditions that place the older group at greater risk of poor prognosis on the course of metastatic disease. 6 In agreement with previous studies, 9,10,13,16 this study demonstrated that comorbid conditions increased with age (hypertension: OR, 4.66; 95% CI, 3.11-6.99; CCS: OR, 2.59; 95% CI, 1.58 -4.24; hCCS: OR, 3.94; 95% CI, 2.73-5.69). Hypertension was the most prevalent comorbid condition among breast cancer patients 9,10,12,13,16,19,37 and was more likely to be found in older patient group.…”

Impact of Radiosurgical Management of Geriatric Patients With Brain Metastases: Clinical and Quality of Life Outcomes

“…Recent clinical trials have shown that WBRT can worsen performance status 2 . Quality of life (QOL) and performance status may be very important in older patients as the aging process can lead older patients to have a lower tolerance to aggressive therapies and less functional reserve to help them recover from clinical decline [8][9][10] . WBRT has also been associated with higher risk of chronic neurotoxicity especially in the older patient population 5,6 .…”