Breast cancer in older women: what factors affect the treatment?

Background. Elderly women with breast cancer are considered underdiagnosed and undertreated, and this adversely affects their overall survival. Between January 2009 and December 2010, 143 patients were admitted and treated for breast cancer at the Azienda Ospedaliera "S. Maria" Terni-Italy. The patients were divided into three groups: 70-74, 75-79, and 80 years and older. Results. Lumpectomy was performed in 42% of all patients, while mastectomy was done in 46% of patients. Adjuvant therapy such as chemotherapy, radiation therapy, and hormonal therapy were done in 12%, 25%, and 38%, respectively. Forty-seven percent of patients with positive lymph nodes received chemotherapy. Eighty-six percent of patients who were estrogen receptor-positive received adjuvant hormonal therapy. Overall five-year survival was only 14% for the ≥80 age group, compared to that of 32% and 35% for the 70-74 and the 75-79 age groups, respectively. Conclusions. Surgery was performed in majority of these patients, about half received lumpectomy, the other half mastectomy. Adjuvant therapies were frequently excluded, with only hormonal therapy being the most commonly used. Overall five-year survival is significantly worse in patients ≥80 years with breast cancer.