Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.
J Surg Oncol. 2011 Mar 1;103(3):201-6. doi: 10.1002/jso.21799. Epub 2010 Nov 23.
The study aim was to investigate the methods of breast cancer diagnosis and treatment for women at advanced ages.
We identified 134 patients ≥ 80 years old treated for breast cancer. Data included patient and tumor characteristics, treatment, and outcomes.
Of 134 women ≥ 80 years old, 146 breast cancers were diagnosed. Sixty-five (45%) were detected by mammography. Surgical therapy included partial mastectomy in 50% and mastectomy in 50%. Although 12 (9%) women had no axillary staging, 22 (16%) underwent axillary lymph node dissection for node-negative disease. Of 73 patients undergoing partial mastectomy, 34 (47%) received adjuvant radiation. Of 113 cancers with known estrogen receptor (ER) status, 83% were ER positive; 95% received endocrine therapy. Fourteen (10%) received adjuvant chemotherapy. Eleven (8%) were Her-2 neu-amplified; one patient received adjuvant trastuzumab. At follow-up, 87 (65%) patients were alive without evidence of disease, while 6 (4%) died of breast cancer.
Breast cancer in women ≥ 80 years is more likely to be early-stage with favorable tumor biology. While most women eligible for anti-estrogen therapy received it, adjuvant radiation, chemotherapy, and/or trastuzumab were utilized infrequently. Despite these variations, older women with breast cancer are unlikely to suffer breast cancer-related mortality.
本研究旨在探讨高龄女性乳腺癌的诊断和治疗方法。
我们确定了 134 名≥80 岁的乳腺癌患者。数据包括患者和肿瘤特征、治疗和结局。
在 134 名≥80 岁的女性中，诊断出 146 例乳腺癌。65 例（45%）经乳房 X 线摄影检查发现。手术治疗包括 50%的局部乳房切除术和 50%的乳房切除术。虽然 12 名（9%）女性未进行腋窝分期，但 22 名（16%）腋窝淋巴结阴性患者行腋窝淋巴结清扫术。在 73 例行局部乳房切除术的患者中，34 例（47%）接受了辅助放疗。在已知雌激素受体（ER）状态的 113 例癌症中，83%为 ER 阳性；95%接受内分泌治疗。14 例（10%）接受辅助化疗。11 例（8%）Her-2 neu 扩增；1 例接受辅助曲妥珠单抗治疗。随访时，87 例（65%）患者无疾病存活，6 例（4%）死于乳腺癌。
≥80 岁女性的乳腺癌更可能处于早期阶段，具有良好的肿瘤生物学特性。虽然大多数符合抗雌激素治疗的女性都接受了治疗，但辅助放疗、化疗和/或曲妥珠单抗的应用并不常见。尽管存在这些差异，但老年乳腺癌患者不太可能死于乳腺癌相关疾病。
