What are the clinicopathological features of elderly early-stage breast cancer patients and is there any difference in patients over 70 years of age?

Abstract

Aim: Although patients over 65 years of age are considered to be elderly patients with breast cancer, theperformance status and comorbidity of patients aged 70 and over is not the same as patients aged 65e70years. The aim of this study was to evaluate the treatment modalities, features of patients and disease inelderly early-stage breast cancer patients.Material and methods: Data of 87 patients were examined. Demographic data, disease data (tumor size,lymph node involvement, hormone receptor status, Her-2 status), comorbid diseases, and given treatments were evaluated. The patients were divided into two groups as 65e70 years of age and over 70years of age. All the collected data was compared.Results: There was no difference in hormone receptor status between 2 groups (p > 0,05). Her-2 negativity was found to be significantly higher in patients $geq$ 70 years (%61 vs %83, p ¼ 0,024). There was nosignificant difference between two groups in terms of surgery (p > 0,05). The frequency of chemotherapyand radiotherapy was significantly lower in the older group (%37 vs %17, p ¼ 0,009). OS and DFS weresignificantly shorter in triple negative disease (69.59 months,p ¼ 0.039 and 53.95 months,p ¼ 0.024respectively). ER positive subtype has a significantly better DFS (164 vs 47 months, p ¼ 0,037) and OS(170 vs 68 months, p ¼ 0,046). Additionally, PR positive disease has a significantly better DFS (129 vs 84months, p ¼ 0,028) and OS (190 vs 96 months, p ¼ 0,006). HER2-negative subtype had better OS thanHER2-positive subtype (172 vs 91 months, p ¼ 0,016). DFS was significantly shorter in $geq$ 70years patients(161.1 months vs 102.1 months, p ¼ 0.045), however OS was not different among the 2 groups. Adjuvanttherapy prolongs DFS in both groups(65e70 years 107,5 vs 129,3 months, >70years 86,2 vs 95,7 monthsp ¼ 0,034).Conclusion: Age is an important and independent risk factor for the treatment of the elderly patients,however patient age alone cannot be decisive. In current study, the pathological features of the tumorand the effects of these features on DFS and OS were similar in young breast cancer patients and patientsover 70 years of age. In addition, we found that adjuvant treatment modalities affect OS and DFS positively as in the case of young patients. There is an absolute need for prospective studies involving elderlypatients.