Under-Treatment and Poorer Survival Outcomes in Elderly Breast Cancer Patients in Singapore: A Comparison with Younger Patients in a Tertiary Institution

Abstract

Introduction: The numbers of elderly patients with breast cancers are increasing with an ageing population, yet clinical research on these patients is still lacking. This study aims to examine the differences between elderly patients and their younger counterparts, with a view to optimize management plans for the former. Methods: Patients ≥ 40 years old with histologically proven breast cancer between 1991 and 2008 were identified from our database, and grouped according to age for analyses: old elderly (≥75 years), young elderly (65 to 74 years) and young (40 to 64 years). Clinicopathologic characteristics, treatment and survival rates were compared across the 3 groups. Results: There were 103 (11.53%) old elderly, 147 (16.5%) young elderly and 643 (72.0%) young patients. The 2 elderly groups presented at later stages, received less adjuvant or palliative chemotherapy (P < 0.001), and less adjuvant radiotherapy (P < 0.001), compared to the younger patients. Both breast cancer specific survival (CSS) and overall survival (OS) in the old elderly (CSS: 64.7% (95% confidence interval [CI]: 53.4%-73.8%), OS: 46.4% (95% CI: 35.6%-56.4%)) and young elderly group (CSS: 82.4% (95% CI: 74.4%-88.0%) OS: 78.6% (95% CI: 70.4%-84.8%)) were lower than the young patient group (CSS: 84.9% (95% CI: 81.6%-87.7%), OS: 83.4% (95% CI: 80.0%-86.3%)) at 5 years. Conclusion: Our findings showed that clinicopathologic characteristics of elderly breast cancer patients differed from their younger counterparts. Poorer survival outcomes among our elderly patients may be the result of their under-treatment.

The Benefits of Physical Activity to Reduce Mortality in Postmenopausal Breast Cancer Patients: A Literature Review

“…Physical Activity in Postmenopausal Breast Cancer Patients options and decision [17][18][19]. Older breast cancer patients are more likely to have a lower quality of life [20], lower survival rate [16,[21][22][23], and experienced 17% higher disease specific-mortality [24] than younger patients. Breast cancer itself is known as the most common cause of death in breast cancer patients within 1 to 5 years after diagnosis, while the most common cause of death within 5 to 10 years or more is due to other causes such as heart disease, followed by cerebrovascular disease, chronic obstructive pulmonary disease (COPD), and Alzheimer's disease [25].…”