title: Determinants of outcome in elderly patients with positive sentinel lymph nodes.
abstract: BACKGROUND
  Older women are less likely to receive standard of care treatment for breast cancer.
  
  
  METHODS
  We examined variables that affected the outcome of elderly patients ≥70 years old among 1,470 patients with invasive cancer with positive sentinel lymph nodes (SLNs).
  
  
  RESULTS
  Elderly patients were less likely to undergo mastectomy, completion axillary node dissection (ALND), adjuvant chemotherapy, and radiotherapy (RT) following breast-conserving therapy (BCT) compared with patients <70 years old. The 5-year risk of disease progression and cumulative incidence of breast cancer-specific deaths were not significantly different for both groups. On multivariate analysis, hormone receptor-negative status, number of metastatic lymph nodes, high nuclear grade, and tumor size were the factors independently associated with increased risk of disease progression.
  
  
  CONCLUSIONS
  Tumor factors were the primary determinants of breast cancer outcomes in our cohort. Elderly patients are less likely to receive aggressive surgical interventions and adjuvant therapy because of perceived life expectancy.
authors.affiliation: Breast Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, Evelyn H. Lauder Breast Center, New York, NY 10065, USA.
authors.forename: Amer K
authors.initials: AK
authors.lastname: Karam
authors.forename: Meier
authors.initials: M
authors.lastname: Hsu
authors.forename: Sujata
authors.initials: S
authors.lastname: Patil
authors.forename: Michelle
authors.initials: M
authors.lastname: Stempel
authors.forename: Tiffany A
authors.initials: TA
authors.lastname: Traina
authors.forename: Alice Y
authors.initials: AY
authors.lastname: Ho
authors.forename: Hiram S
authors.initials: HS
authors.lastname: Cody
authors.forename: Monica
authors.initials: M
authors.lastname: Morrow
authors.forename: Mary L
authors.initials: ML
authors.lastname: Gemignani
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D001943:Breast Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000556:secondary*; D002423:Cause of Death / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D018571:Sentinel Surveillance; D014481:United States / Q000453:epidemiology; D055815:Young Adult