title: In breast cancer, are treatments and survival the same whatever a patient's age? A population-based study over the period 1998-2009.
abstract: OBJECTIVE
  The present study aimed to describe treatments, relative survival and prognostic factors in breast cancer patients according to age.
  
  
  METHODS
  All women with primary invasive breast cancer, diagnosed from 1998 to 2009 in the department of Côte d'Or, were retrospectively selected. Variations in treatments administered according to age (<50 years, 50-74 years, >74 years) and period were assessed using Cochran-Armitage trend tests and χ(2) -tests, respectively. Prognostic factors according to age were estimated using a generalized linear model with a Poisson error structure.
  
  
  RESULTS
  Overall, 4305 women were included. The oldest women (aged >74 years) were more likely than the youngest women to have comorbidities, advanced stage tumors, hormone receptor-positive tumors and be human epidermal growth factor receptor 2-negative. The use of breast conserving surgery plus adjuvant therapy decreased in older women (>74 years), whereas the proportions of women without treatments and with adjuvant hormone therapy increased with age. Multivariate relative survival analyses according to age showed an increased risk of death in women aged 50-74 years and >74 years with comorbidities compared with those without comorbidities; relative excess risks were 1.85 (1.13-3.02) and 3.23 (1.26-8.31), respectively. In contrast, a decreased risk of death was observed in women aged 50-74 years diagnosed by medical imaging compared with those diagnosed by clinical signs; relative excess risks 0.44 (0.22-0.89).
  
  
  CONCLUSIONS
  Elderly women compared with the youngest women were diagnosed with more favorable tumor biology (hormone receptor-positive tumors, human epidermal growth factor receptor 2-negative). However, survival was poor in elderly women who had comorbid conditions, did not attend screening mammography examinations and were undertreated.
authors.affiliation: Breast and Gynaecologic Cancer Registry of Côte d'Or, Centre Georges François Leclerc Comprehensive Cancer Centre, Dijon Cedex, France; EA 4184, Faculty of Medicine, University of Burgundy, Dijon, France.
authors.forename: Pegdwende Olivia
authors.initials: PO
authors.lastname: Dialla
authors.forename: Valérie
authors.initials: V
authors.lastname: Quipourt
authors.forename: Julie
authors.initials: J
authors.lastname: Gentil
authors.forename: Sophie
authors.initials: S
authors.lastname: Marilier
authors.forename: Marie-Laure
authors.initials: ML
authors.lastname: Poillot
authors.forename: Patrick
authors.initials: P
authors.lastname: Roignot
authors.forename: Thierry
authors.initials: T
authors.lastname: Altwegg
authors.forename: Ariane
authors.initials: A
authors.lastname: Darut-Jouve
authors.forename: Sévérine
authors.initials: S
authors.lastname: Guiu
authors.forename: Patrick
authors.initials: P
authors.lastname: Arveux
authors.forename: Tienhan Sandrine
authors.initials: TS
authors.lastname: Dabakuyo-Yonli
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000401:mortality* / Q000628:therapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors
keywords: aging; breast cancer; prognostic factors; relative survival; treatments