title: Effects of comorbidities and functional living activities on survival in geriatric breast cancer patients.
abstract: OBJECTIVE
  We evaluated the possible effects of comorbid diseases and functional capacity on the survival of elderly female patients with breast cancer.
  
  
  METHODS
  The study included 159 breast cancer patients aged 65 years or older. Functional status of the patients was evaluated using Katz's index of activities of daily living (ADL) and Lawton and Brody's Instrumental ADL (IADL) scale.
  
  
  RESULTS
  ADL-based evaluation revealed 121 patients (76.1%) were independent, 34 (21.4%) semi-dependent and 4 (2.5%) dependent whereas IADL-based evaluation showed 69 patients (43.4%) were independent, 67 patients (42.1%) semi-dependent and 23 patients (14.5%) dependent. Among the patients, 69 (43.4%) had one comorbid disease, 62 (39.0%) had two and 26 (16.4%) had three or more. Of the entire cohort, 60.4% received adjuvant chemotherapy. Based on ADL index, overall survival (OS) was significantly better in semi-dependent and independent patients than in dependent patients (p = 0.001). In the upfront non-metastatic patient subgroup, disease-free survival (DFS) was favourable in the independent patients according to ADL index (p = 0.001). Having more than one comorbid disease had an unfavourable effect on OS. In the multiple regression analysis of non-metastatic patients, stage, triple-negative histology and ADL index remained significant in terms of OS (p = 0.008, HR: 3.17, CI: 1.35-7.44; p = 0.027, HR: 2.78, CI: 1.172-6.91; and p = 0.006, HR: 0.29, CI: 0.12-0.70, respectively).
  
  
  CONCLUSIONS
  In elderly patients with breast cancer, evaluation of daily living activities and comorbid diseases are as important as staging and subclassification of breast cancer in the determination of prognosis and survival.
authors.affiliation: Ankara Dr AY Oncology Training and Research Hospital, Department of Medical Oncology, Ankara, Turkey.
authors.forename: Ozlem U
authors.initials: OU
authors.lastname: Sonmez
authors.affiliation: Ankara Dr AY Oncology Training and Research Hospital, Department of Medical Oncology, Ankara, Turkey.
authors.forename: Ulku Y
authors.initials: UY
authors.lastname: Arslan
authors.affiliation: Ankara Dr AY Oncology Training and Research Hospital, Department of Medical Oncology, Ankara, Turkey.
authors.forename: Onur
authors.initials: O
authors.lastname: Esbah
authors.affiliation: Ankara Dr AY Oncology Training and Research Hospital, Department of Medical Oncology, Ankara, Turkey.
authors.forename: Kaan
authors.initials: K
authors.lastname: Helvaci
authors.affiliation: Ankara Dr AY Oncology Training and Research Hospital, Department of Medical Oncology, Ankara, Turkey.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Turker
authors.affiliation: Ankara Dr AY Oncology Training and Research Hospital, Department of Medical Oncology, Ankara, Turkey.
authors.forename: Ummugul
authors.initials: U
authors.lastname: Uyeturk
authors.affiliation: Ankara Dr AY Oncology Training and Research Hospital, Department of Medical Oncology, Ankara, Turkey.
authors.forename: Burcin
authors.initials: B
authors.lastname: Budakoglu
authors.affiliation: Ankara Dr AY Oncology Training and Research Hospital, Department of Medical Oncology, Ankara, Turkey.
authors.forename: Oznur
authors.initials: O
authors.lastname: Bal
authors.affiliation: Ankara Dr AY Oncology Training and Research Hospital, Department of Medical Oncology, Ankara, Turkey.
authors.forename: Berna
authors.initials: B
authors.lastname: Oksuzoglu
keywords: breast; cancer; geriatric