title: Assessment of surgical treatment in elderly patients with breast cancer.
abstract: OBJECTIVE
  The incidence of breast cancer increases with advancing age and in clinical practice approximately 50% of new cases occur in women over the age of 65 years. Although breast cancer in elderly patients presents more favorable biological characteristics than similar-stage cancer in younger women, disease control still remains uncertain and is becoming a major health problem.
  
  
  METHODS
  Between 1984 and 2006, 133 patients aged over 65 with operable breast cancer underwent surgical treatment. Patients with ductal or lobular carcinoma in situ, bilateral breast cancer or a previous malignancy were excluded. The mean age was 72.8 years (range, 66-89). Breast-conserving surgery was performed in patients with early breast cancer (T1, T2 < 2.5 cm), while most patients with advanced tumors (T2 >2.5 cm, T3, T4) were treated by modified radical mastectomy.
  
  
  RESULTS
  The pathological stage was I in 44, IIA in 54, IIB in 18, IIIA in 10 and IIIB in 7 patients. Postoperative complications occurred in 13 patients (9%); there were no postoperative deaths. Eighty-nine patients underwent adjuvant therapy (chemotherapy, hormonal therapy). After a median follow-up of 96 months (range, 5-266), disease progression was observed in 21 patients (15.8%). The overall mortality from breast cancer was 11%, whereas the cancer-unrelated mortality was 9%.
  
  
  CONCLUSIONS
  There is no evidence that breast cancer has a more favorable prognosis in the elderly and surgical procedures should be carried out as has been established in younger women. At present, elderly patients are much less likely to be entered into randomized clinical trials and are often undertreated. However, in the absence of serious comorbid disease, they are able to withstand standard multimodal treatment options as well as do younger patients.
authors.affiliation: Department of Surgery Pietro Valdoni, University of Rome Sapienza, Rome, Italy. alessandro.decesare@tin.it
authors.forename: Alessandro
authors.initials: A
authors.lastname: De Cesare
authors.forename: Antonio
authors.initials: A
authors.lastname: Burza
authors.forename: Enrico
authors.initials: E
authors.lastname: Fiori
authors.forename: Marco
authors.initials: M
authors.lastname: Bononi
authors.forename: Patrizia
authors.initials: P
authors.lastname: Volpino
authors.forename: Giovanni
authors.initials: G
authors.lastname: Leone
authors.forename: Alessandro
authors.initials: A
authors.lastname: Crocetti
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Cangemi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D014408:Biomarkers, Tumor / Q000032:analysis; D001943:Breast Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000601:surgery*; D002278:Carcinoma in Situ / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000601:surgery; D018275:Carcinoma, Lobular / Q000601:surgery; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008408:Mastectomy / Q000379:methods; D009367:Neoplasm Staging; D011960:Receptors, Estrogen / Q000032:analysis; D011980:Receptors, Progesterone / Q000032:analysis; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone