Do elderly breast cancer patients have poorer survival outcome?

Abstract

Objective: This study is to compare breast cancer in elderly patients to their younger counterparts, and look for factors affecting survival of elderly patients. Methodology: A retrospective study of breast cancer patients who had surgery in a university hospital from 2000 to 2015 was performed. Stage on presentation, tumor characteristics and modalities of treatment for patients aged 70 and above were compared with those aged below 70. Factors affecting breast cancer specific survival were assessed by multivariate cox regression. Results: 3825 patients with breast cancer underwent surgery during the study period. 510 patients (13.3%) were aged 70 and above. The 5 year overall survival for elderly patients was 76.9%, which was poorer than their younger counterparts 89.5% (p=0.000). By multivariate analysis, use of adjuvant hormonal therapy (p=0.001, HR 0.481), advanced T stage (p<0.05) and advanced N stage (p<0.001) were the independent factors affecting breast cancer specific survival in elderly patients. Conclusions: Elderly breast cancer patients had worse overall and breast cancer specific survival. Stage on presentation and use of adjuvant hormonal therapy were independent factors affecting the survival in elderly patients. Early diagnosis and comprehensive geriatric assessment to guide the optimal treatment plan would be useful for better survival outcome in elderly breast cancer patients.