title: Surgery improves survival in elderly with breast cancer. A study of 465 patients in a single institution.
abstract: BACKGROUND
  Breast cancer treatment in elderly patients is controversial. This single-centre study was conducted to review the treatment and outcomes for octogenarian women treated for breast cancer.
  
  
  METHODS
  Data from all patients aged 80 years or more with primary breast cancer treated at our institution between 1995 and 2012 were included. Patients with carcinoma in-situ (stage 0) and advanced breast cancer (stage IV) were excluded.
  
  
  RESULTS
  The study population consisted of 369 patients (median age 84 years). A total of 277 (75%) patients underwent surgical treatment (PST) and 92 (25%) received primary endocrine treatment (PET). Prognostic factors (HER-2, tumour grade, lymphovascular invasion and subsequent adjuvant therapy) were homogeneously distributed in both groups. PST and PET were stratified according to stage: 273 (66%) patients with early stage disease (I, IIA, IIB) and 96 (34%) with locally advanced disease (IIIA, IIIB, IIIC). Patients were followed-up for a median of 63 months. In patients with early stage disease, the mean breast cancer-specific survival (BCSS) was 109 months (95% CI = 101-115) in PST patients, and 50 months (95% CI = 40-60) in PET patients (P < 0.01). Conversely, for patients with locally advanced breast cancer, there was no significant difference in BCSS between the surgical and non-surgical groups. In the PST group, BCSS and disease-free survival were significantly better among patients who underwent standard surgical treatment than among those who received suboptimal treatment. There were no differences in the Charlson comorbidity index scores between the PST and PET groups.
  
  
  CONCLUSIONS
  In women ≥80 years with early-stage breast cancer, standard surgical treatment was associated with a better BCSS when compared with PET.
authors.affiliation: Breast Cancer Unit, Department of Obstetrics and Gynaecology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain. Electronic address: tomascortadellas@hotmail.com.
authors.forename: T
authors.initials: T
authors.lastname: Cortadellas
authors.affiliation: Breast Cancer Unit, Department of Obstetrics and Gynaecology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: O
authors.initials: O
authors.lastname: Córdoba
authors.affiliation: Breast Cancer Unit, Department of Obstetrics and Gynaecology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Gascón
authors.affiliation: Breast Cancer Unit, Department of Obstetrics and Gynaecology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Haladjian
authors.affiliation: Breast Cancer Unit, Department of Obstetrics and Gynaecology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Bernabeu
authors.affiliation: Breast Cancer Unit, Department of Obstetrics and Gynaecology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Alcalde
authors.affiliation: Breast Cancer Unit, Department of Obstetrics and Gynaecology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Esgueva
authors.affiliation: Breast Cancer Unit, Department of Obstetrics and Gynaecology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Rodriguez-Revuelto
authors.affiliation: Breast Cancer Unit, Department of Obstetrics and Gynaecology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Espinosa-Bravo
authors.affiliation: Breast Cancer Unit, Department of Obstetrics and Gynaecology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Díaz-Botero
authors.affiliation: Breast Cancer Unit, Department of Obstetrics and Gynaecology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Xercavins
authors.affiliation: Breast Cancer Unit, Department of Obstetrics and Gynaecology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: I T
authors.initials: IT
authors.lastname: Rubio
authors.affiliation: Breast Cancer Unit, Department of Obstetrics and Gynaecology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Gil-Moreno
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000628:therapy; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D018270:Carcinoma, Ductal, Breast / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D018275:Carcinoma, Lobular / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008408:Mastectomy; D009367:Neoplasm Staging; D011878:Radiotherapy; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D012189:Retrospective Studies
chemical_list: D018931:Antineoplastic Agents, Hormonal; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; C508053:ERBB2 protein, human
keywords: Breast cancer; Breast cancer-specific survival; Charlson comorbidity; Elderly patients; Primary endocrine therapy; Primary surgical treatment