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Journal of Breast Disease > Volume 8(1); 2020 > Article
Journal of Breast Disease 2020;8(1): 25-36. doi: https://doi.org/10.14449/jbd.2020.8.1.25
Treatment Patterns and Clinical Outcomes in Elderly Patients with Breast Cancer
Kyu Min Kang, M.D., Eun-Kyu Kim, M.D., Ph.D., Hyunju Kim, M.D., Jee Hyun Kim, M.D., Ph.D.1, Se Hyun Kim, M.D.1, Koung Jin Suh, M.D.1, In Ah Kim, M.D., Ph.D.2, Sumin Chae, M.D.3, Sung-Won Kim, M.D., Ph.D.4, Eunyoung Kang, M.D., Ph.D.
Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
1Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
2Department of Radiation Oncology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
3Department of Surgery, Kyung Hee University School of Medicine, Kyung Hee University Medical Center, Seoul, Korea
4Department of Surgery, Daerim St. Mary’s Hospital, Seoul, Korea
Corresponding Author: Eunyoung Kang ,Tel: +82-31-787-7102, Fax: +82-31-787-4078, Email: key5002@gmail.com
Received: November 19, 2019    Revised: January 13, 2020    Accepted: February 18, 2020
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ABSTRACT
Purpose: Although the number of elderly patients with breast cancer is increasing as the population ages, their treatment is controversial. We evaluated the prognostic factors associated with survival in elderly breast cancer patients and assessed the impact of comorbidity on prognosis.
Methods: This study included 362 patients (aged ≥65 years) who underwent surgery for breast cancer in our institution between 2003 and 2014. The patients were divided into early-aged (65–74 years) and late-aged (≥75 years) groups. Comorbidity was parametrized using the Charlson comorbidity index (CCI). Kaplan–Meier analysis was used to analyze overall survival (OS) and distant metastasis-free survival (DMFS). Prognostic factors were evaluated by Cox proportional hazards regression.
Results: The surgical method, subtypes, stage, and oncological features were similar between early- and late-aged groups; however, smaller proportions of patients in the late-aged group received chemotherapy (12.9% vs. 45.5%) and endocrine therapy (55.3% vs. 73.3%). In multivariable analysis, the poor prognostic factors associated with DMFS and OS were high CCI, high histologic grade, and advanced stage. Chemotherapy, endocrine therapy, and radiotherapy were not significantly related to DMFS and OS.
Conclusions: In this study, adjuvant treatments did not affect the prognosis of elderly patients with breast cancer. To clarify the effects of adjuvant therapies in these patients, a large-scale retrospective study that considers not only tumor characteristics but also life expectancy is necessary.
Keywords: Aged | Breast neoplasms | Comorbidity | Prognosis
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