title: Breast cancer in elderly women (≥ 80 years): variation in standard of care?
abstract: OBJECTIVE
  The study aim was to investigate the methods of breast cancer diagnosis and treatment for women at advanced ages.
  
  
  METHODS
  We identified 134 patients ≥ 80 years old treated for breast cancer. Data included patient and tumor characteristics, treatment, and outcomes.
  
  
  RESULTS
  Of 134 women ≥ 80 years old, 146 breast cancers were diagnosed. Sixty-five (45%) were detected by mammography. Surgical therapy included partial mastectomy in 50% and mastectomy in 50%. Although 12 (9%) women had no axillary staging, 22 (16%) underwent axillary lymph node dissection for node-negative disease. Of 73 patients undergoing partial mastectomy, 34 (47%) received adjuvant radiation. Of 113 cancers with known estrogen receptor (ER) status, 83% were ER positive; 95% received endocrine therapy. Fourteen (10%) received adjuvant chemotherapy. Eleven (8%) were Her-2 neu-amplified; one patient received adjuvant trastuzumab. At follow-up, 87 (65%) patients were alive without evidence of disease, while 6 (4%) died of breast cancer.
  
  
  CONCLUSIONS
  Breast cancer in women ≥ 80 years is more likely to be early-stage with favorable tumor biology. While most women eligible for anti-estrogen therapy received it, adjuvant radiation, chemotherapy, and/or trastuzumab were utilized infrequently. Despite these variations, older women with breast cancer are unlikely to suffer breast cancer-related mortality.
authors.affiliation: Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.
authors.forename: Amy
authors.initials: A
authors.lastname: Cyr
authors.forename: William E
authors.initials: WE
authors.lastname: Gillanders
authors.forename: Rebecca L
authors.initials: RL
authors.lastname: Aft
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Eberlein
authors.forename: Julie A
authors.initials: JA
authors.lastname: Margenthaler
mesh_terms: D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy*; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental; D009367:Neoplasm Staging; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome