Determinants of outcome in elderly patients with positive sentinel lymph nodes.
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.
Karam
Amer K
AK
Breast Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, Evelyn H. Lauder Breast Center, New York, NY 10065, USA.
Hsu
Meier
M
Patil
Sujata
S
Stempel
Michelle
M
Traina
Tiffany A
TA
Ho
Alice Y
AY
Cody
Hiram S
HS
Morrow
Monica
M
Gemignani
Mary L
ML
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