title: Surgery improves breast cancer-specific survival in octogenarians with early-stage breast cancer.
abstract: BACKGROUND
  No consensus exists on optimum therapy for older cancer patients. This singlecentre study was conducted to review the treatment and outcomes for octogenarian women treated for breast cancer.
  
  
  METHODS
  Data of all elderly breast cancer patients (≥80 years) with primary breast cancer treated at out institution between 1990 and 2009. Patients with carcinoma in-situ (stage 0) and advanced breast cancer (stage IV) were excluded. Breast cancer-specific survival and disease-free survival for the different patient groups were analysed according to the Kaplan-Meier method.
  
  
  RESULTS
  The study population consisted of 259 patients (median age 84 years). There were 189 (73%) patients with early stage disease (I, IIA, IIB) and 70 (27%) with locally advanced disease (IIIA, IIIB, IIIC). A total of 175 (67.7%) patients underwent surgical treatment and 84 (32.4%) received primary endocrine treatment. Patients were followed for a median of 65 months. In patients with early stages, the mean breast cancer-specific survival was 108 months (95% CI 101-115) in the surgical group and 50 months (95% CI 39-61) in the non-surgical group (P < 0.01), whereas patients with locally advanced breast cancer breast cancer-specific survival was similar for the surgical and non-surgical groups. Breast cancer-specific survival and disease-free survival were significantly better among patients who underwent standard surgical treatment than among those with suboptimal surgery.
  
  
  CONCLUSIONS
  In women ≥80 years with early-stage breast cancer, standard surgical treatment as compared with non-surgical therapy was associated with a better breast cancer-specific.
authors.affiliation: Breast Cancer Unit, Department of Obstetrics and Gynecology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 119-129, E-08035 Barcelona, Spain. tomascortadellas@hotmail.com
authors.forename: Tomás
authors.initials: T
authors.lastname: Cortadellas
authors.forename: Andrea
authors.initials: A
authors.lastname: Gascón
authors.forename: Octavi
authors.initials: O
authors.lastname: Córdoba
authors.forename: Jordi
authors.initials: J
authors.lastname: Rabasa
authors.forename: Robert
authors.initials: R
authors.lastname: Rodríguez
authors.forename: Martin
authors.initials: M
authors.lastname: Espinosa-Bravo
authors.forename: Antonio
authors.initials: A
authors.lastname: Esgueva
authors.forename: Isabel T
authors.initials: IT
authors.lastname: Rubio
authors.forename: Jordi
authors.initials: J
authors.lastname: Xercavins
authors.forename: Antonio
authors.initials: A
authors.lastname: Gil
mesh_terms: D000367:Age Factors; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
chemical_list: D018931:Antineoplastic Agents, Hormonal
keywords: Breast cancer; Breast cancer-specific survival; Octogenarian patients; Primary endocrine therapy; Standard surgical treatment