title: Surgical treatment of breast cancer in patients aged 80 years or older--how much is enough?
abstract: BACKGROUND
  The population of elderly people is increasing and so is the population of breast cancer patients aged ≥80 years. The aim of our retrospective study was to identify independent prognostic factors for the duration of breast cancer-specific survival of surgically treated patients aged ≥80 years. The secondary aim was to determine the appropriate surgical treatment of breast cancer in patients aged ≥80 years.
  
  
  METHODS
  We reviewed the medical records of 154 patients aged ≥80 years with early-stage breast cancer (mean age 83 years) who underwent surgery at the tertiary cancer center in the period from 2000 to 2008. Tumor stage was pT1/pT2 and pT3/pT4 in 75% and 25%, respectively. Surgical treatment comprised: quadrantectomy (in 27%), mastectomy (in 73%), axillary dissection (in 57%), and sentinel lymph node biopsy (in 18%), while 25% of patients had no axillary surgery.
  
  
  RESULTS
  During a median follow-up of 5.3 years, 31% of patients died of breast cancer, while 28% of patients died of other causes. Half of our patients with poorly differentiated breast cancer or estrogen receptor-negative tumor died of breast cancer. Multivariate statistical analysis showed that the pathological T-stage, pathological N-stage and estrogen receptors were independent prognostic factors for the duration of breast cancer-specific survival of patients.
  
  
  CONCLUSIONS
  Short breast cancer-specific survival indicates that, in patients aged ≥80 years, breast cancer with metastases in axillary lymph nodes can be an aggressive disease.
authors.affiliation: Department of Surgical Oncology, Institute of Oncology, Zaloska 2, SI-1000 Ljubljana, Slovenia. nbesic@onko-i.si.
authors.forename: Nikola
authors.initials: N
authors.lastname: Besic
authors.forename: Hana
authors.initials: H
authors.lastname: Besic
authors.forename: Barbara
authors.initials: B
authors.lastname: Peric
authors.forename: Gasper
authors.initials: G
authors.lastname: Pilko
authors.forename: Rok
authors.initials: R
authors.lastname: Petric
authors.forename: Jan
authors.initials: J
authors.lastname: Zmuc
authors.forename: Radan
authors.initials: R
authors.lastname: Dzodic
authors.forename: Andraz
authors.initials: A
authors.lastname: Perhavec
mesh_terms: D000367:Age Factors; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy