title: Breast cancer and clinical outcome among women over 60 years of age: a plead for more screening and alternative treatments.
abstract: OBJECTIVE
  To study elderly women > or = 60 years of age diagnosed with breast cancer and analyze this cohort according to death from breast cancer and death due to comorbidities. Patients aged 60-69 years of age were included in routine mammography screening, but not women aged > or = 70 years. This enabled a comparison between the 2 groups regarding screening effect, tumor size and survival in breast cancer.
  
  
  METHODS
  A consecutive sample of 311 breast cancer patients > or = 60 years of age from 1991 were analyzed according to tumor size at diagnosis, frequencies of lymph node metastasis, tumor histological grade and stage, ploidy, proliferation index, stem-line-scatter index and survival rate in breast cancer and other causes of death. Tumor size was compared to a patient group aged 60-69 from 1987, before the introduction of mammography screening in Sweden.
  
  
  RESULTS
  In the screening group a significant reduction in tumor size was found at diagnosis compared to the sample from 1987 (p < 0.001) and to the older group > or = 70 years (p < 0.02). In the latter group a higher death rate appeared for breast cancer.
  
  
  CONCLUSIONS
  Older women would have a better outcome if included in the mammography screening program.
authors.affiliation: Departments of Oncology and Pathology, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden. roland.sennerstam@ki.se
authors.forename: Roland B
authors.initials: RB
authors.lastname: Sennerstam
authors.forename: Hans
authors.initials: H
authors.lastname: Wiksell
authors.forename: Kai-Uwe
authors.initials: KU
authors.lastname: Schässburger
authors.forename: Gert U
authors.initials: GU
authors.lastname: Auer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology*; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D013548:Sweden / Q000453:epidemiology; D016896:Treatment Outcome