title: Undertreatment of breast cancer in the elderly.
abstract: OBJECTIVE
  The effect of undertreatment with adjuvant hormonal therapy, chemotherapy or radiation was studied in elderly women with breast cancer.
  
  
  METHODS
  A prospectively maintained database was used to identify women undergoing potentially curative surgery between 1997 and 2011. The presentation, pathologic findings, treatment and outcomes of 449 women over 65 were compared to the findings in 1049 younger patients. Moreover, conventionally treated and undertreated elderly patients were identified and their characteristics and outcomes were compared.
  
  
  RESULTS
  Both young and old patients presented most frequently with mammographic findings, but older patients presented more frequently with mammographic masses while younger patients presented more frequently with mammographic calcifications. Cancers of older patients were signicantly more favorable than cancers in younger patients with more infiltrating lobular, fewer ductal carcinoma in situ and more frequently estrogen receptor positive and fewer were poorly differentiated. Elderly patients had less axillary surgery, less adjuvant radiation therapy and more hormonal therapy. Fourty-six percent of the 449 elderly patients were undertreated by conventional criteria. Undertreated patients were more frequently in situ, better differentiated, smaller, and more often estrogen receptor positive. Forty-four percent of the undertreated patients died during follow-up without disease recurrence.
  
  
  CONCLUSIONS
  Despite undertreatment, local and distant disease-free survival was comparable to patients who were not undertreated.
authors.forename: Nicola
authors.initials: N
authors.lastname: Rocco
authors.forename: Corrado
authors.initials: C
authors.lastname: Rispoli
authors.forename: Gennaro
authors.initials: G
authors.lastname: Pagano
authors.forename: Silvio
authors.initials: S
authors.lastname: Ascione
authors.forename: Rita
authors.initials: R
authors.lastname: Compagna
authors.forename: Michele
authors.initials: M
authors.lastname: Danzi
authors.forename: Antonello
authors.initials: A
authors.lastname: Accurso
authors.forename: Bruno
authors.initials: B
authors.lastname: Amato
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D013812:Therapeutics / Q000706:statistics & numerical data; D055815:Young Adult