The Clinical Characteristics and Outcome of Breast Cancer Patients Older than 70 Years

Jung Sun Lee; Soo Jung Hong; Hee Jeong Kim; Byung Ho Son; Sung Bae Kim; Jin Hee Ahn; Seung Do Ahn; Sei Hyun Ahn

doi:10.4048/jbc.2007.10.3.199

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Lee, Hong, Kim, Son, Kim, Ahn, Ahn, and Ahn: The Clinical Characteristics and Outcome of Breast Cancer Patients Older than 70 Years

Original Article

Journal of Breast Cancer

Journal of Breast Cancer 2007; 10(3): 199-205.

Published online: 30 September 2007

DOI: https://doi.org/10.4048/jbc.2007.10.3.199

The Clinical Characteristics and Outcome of Breast Cancer Patients Older than 70 Years

Jung Sun Lee, Soo Jung Hong, Hee Jeong Kim, Byung Ho Son, Sung Bae Kim¹, Jin Hee Ahn¹, Seung Do Ahn², Sei Hyun Ahn

Department of Surgery, University of Ulsan, College of Medicine and Asan Medical Center, Seoul, Korea.

¹Department of Oncology, University of Ulsan, College of Medicine and Asan Medical Center, Seoul, Korea.

²Department of Radiologic Oncology, University of Ulsan, College of Medicine and Asan Medical Center, Seoul, Korea.

ahnsh@amc.seoul.kr

Received 16 February 2007 Accepted 6 August 2007

Abstract

Purpose

There is no concensus on the type of therapy useful for elderly cancer patients. Since 2000, Korea has become an elderly society. This study aims to assess clinical characteristics of elderly breast cancer women, and to evaluate determinants and effects of treatment choice for breast cancer prognosis among elderly patients.

Methods

We reviewed the clinical reports of 123 breast cancer patients aged ≥70 yr recorded at the Asan Medical Center Breast Cancer Registry between 1992 and 2002. Patient and tumor chariteristics, comorbidity, surgical method, adjuvant therapy and cause of death were taken into consideration. Survival analysis was determined according to the treatment method.

Results

The median time to diagnosis was 33.6 months. Only 9 patients (5.1%) were diagnosed in the screening program. A modified radical mastectomy was performed for 74 patients (60.1%), Breast conserving surgery was performed for 26 patients (24.7%), and there was no further curative therapy for 12 patients (9.7%). 32 patients (38.1%) had axillary lymph node metastasis. The median follow-up duration was 43.1 months; the overall survival rate was 71.8%, and the disease free survival rate was 65.4%. Breast cancer related mortality was 62.8%.

Conclusion

Delayed diagnosis and infrequent screening were frequent among elderly patients. Cancer related morbidity was less than general breast cancer patients. Treatment needs to be adapted to the general health status of the patient and comorbid conditions, but has to offer the best chance of cure, regardless of age.

Keywords: Elderly women, Breast cancer, Adjuvant therapy

Figures and Tables

Fig 1

Overall survival according to stage. Log-rank test p<0.001.

Fig 2

Overall survival according to axillary lymph node metastasis. Log-rank test p=0.05.

Fig 3

Overall survival according to hormone receptor status. Log-rank test p=0.003.

Table 1

Characteristics among women aged ≥70 yr with breast cancer

Table 2

Characteristics among women aged ≥70 yr with breast cancer

MRM=Modified radical mastectomy; BCO=Breast conserving operation; IHC=Immunohistochemistry.

Table 3

Distribution of adjuvant systemic therapy according to lymph node and hormone receptor status and outcome according to adjuvant therapy

HR=Hormone receptor (Estrogen receptor or Progesteron receptor); CTx=sytemic chemotherapy or Doxifluridine; nc=not countable.

^*Log-rank test.

Table 4

Univariate analysis of factors affecting overall survival

MRM=Modified radical mastectomy; BCO=Breast conserving operation; HR=Estrogen receptor or/and progesterone receptor.

^*Mean survival (median is not achieved); ^†Log-rank test.

Table 5

Multivariate analysis on factors affecting overall survival

LN=Lymph node metastasis; HR=Estrogen receptor or/and progesterone receptor.

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