title: How long are elderly patients followed up with mammography after the diagnosis of breast cancer? A single-centre experience in a developing country.
abstract: BACKGROUND
  The effect of breast cancer on elderly South African (SA) patients is not well characterised. The lack of data with regard to disease burden, post-treatment surveillance and breast cancer relapse poses a challenge to providing optimum follow-up care to this group of patients.
  
  
  OBJECTIVE
  To assess the effect of breast cancer and adherence to post-treatment surveillance programmes among the local elderly population attending the breast oncology clinics at Addington and Inkosi Albert Luthuli Central hospitals in Durban, KwaZulu-Natal, SA.
  
  
  METHODS
  A retrospective review was undertaken of all patients aged ≥65 years diagnosed with breast cancer during 2007. Hospital records were reviewed for a period of 5 years to ascertain the stage of the disease, treatment received, adherence to post-treatment surveillance mammograms, incidence of new mammographic findings and recurrence, site of recurrence, mode of detection of recurrence, disease-free survival, and overall survival rates at 5 years.
  
  
  RESULTS
  In our study, the incidence of breast cancer in the elderly population was 26.7%. A significant percentage of patients (56.3%) were diagnosed at an advanced stage of disease. Of the 46.9% who had received surveillance mammography, only 6.3% received their post-treatment surveillance mammograms on time, in accordance with international recommendations. New mammographic findings were detected in 26.7% of patients during the 5-year follow-up. During the follow-up period, 15.6% of the total number of study patients presented with disease recurrence. Eighty percent of cases of recurrence were detected clinically. The overall survival at 5 years was 65.6%.
  
  
  CONCLUSIONS
  Our study highlights the significant number of elderly patients with advanced disease at diagnosis, poor compliance with internationally recommended annual post-treatment surveillance mammograms, and the relatively low overall 5-year survival rate compared with that of international studies.
authors.affiliation: Department of Radiology, Faculty of Health Sciences, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa. yethiksha@gmail.com.
authors.forename: Yethiksha
authors.initials: Y
authors.lastname: Parag
authors.forename: Ines
authors.initials: I
authors.lastname: Buccimazza