Kuzan T Y, Koca E, Dizdar O, Arslan C, Eren T, Yalcin S, Kucukoztas N, Aksoy S, Rahatli S, Dede D S, Altundag O, Zengin N, Ozyilkan O, Altundag K
Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey.
J BUON. 2013 Apr-Jun;18(2):328-34.
Breast cancer incidence increases in the elderly but data on treatment and outcomes of elderly patients is limited. We assessed the clinicopathological features and outcomes of our patients with breast cancer aged ≥80 years in comparison with their younger postmenopausal counterparts.
The records of 83 patients diagnosed with breast cancer after the age of 80 (group 1) between 2003 and 2011 in 4 different centers were retrospectively evaluated and the clinicopathological features and outcomes were assessed in comparison with a control group (group 2) of 249 patients aged between 60-70 years.
Median ages at diagnosis were 82 years (range 80-95) and 64 years (range 60-70) for group 1 and group 2, respectively. The incidence of invasive cancers other than ductal or lobular type was higher in group 1 than in group 2 (20 vs 8%; p=0.0177rpar;. More patients in group 1 had Charlson Comorbidty scores ≥1 than those in group 2 (49 vs 36%; p=0.011). Patients in group 1 had more conservative operations and less axillary node dissections (ALND) and they received chemotherapy, trastuzumab or radiotherapy less frequently compared to their younger counterparts in group 2. Median follow up period was 36 months (range 1-178) in group 1 and 24 months (range 12-217) in group 2. Five-year disease free survival (DFS) was 53.7 and 75.9) (p=0.005), 5-year overall survival (OS) was 61.9% and 80.47percnt; in group 1 and group 2 (p=0.001), respectively. Advanced stage (stage IV vs stage I, II, III, p=0.051) and cerbB2 positivity (p<0.001) were found to be associated with shorter DFS in patients ≥80 years of age.
Although the majority of patients were undertreated in our study according to the current guidelines, mortality rates were quite low. Different biology of the disease in the elderly might explain this difference.
老年乳腺癌发病率上升，但老年患者治疗及预后的数据有限。我们评估了年龄≥80岁的乳腺癌患者的临床病理特征及预后，并与绝经后较年轻的乳腺癌患者进行比较。
回顾性评估2003年至2011年间在4个不同中心诊断为乳腺癌且年龄在80岁以后的83例患者（第1组）的记录，并与249例年龄在60 - 70岁的对照组（第2组）比较其临床病理特征及预后。
第1组和第2组诊断时的中位年龄分别为82岁（范围80 - 95岁）和64岁（范围60 - 70岁）。第1组中除导管或小叶型以外的浸润性癌发生率高于第2组（20%对8%；p = 0.0177）。第1组中Charlson合并症评分≥1的患者比第2组更多（49%对36%；p = 0.011）。第组患者的手术更保守，腋窝淋巴结清扫术（ALND）更少，与第2组的年轻患者相比，他们接受化疗、曲妥珠单抗或放疗的频率更低。第1组的中位随访期为36个月（范围1 - 178个月），第2组为24个月（范围12 - 217个月）。第1组和第2组的5年无病生存率（DFS）分别为53.7%和75.9%（p = 0.005），5年总生存率（OS）分别为61.%,9%和80.47%（p = 0.001）。晚期（IV期对I、II、III期，p = 0.051）和cerbB2阳性（p < 0.001）与≥80岁患者的DFS缩短有关。
尽管根据当前指南，我们研究中的大多数患者治疗不足，但死亡率相当低。老年患者疾病的不同生物学特性可能解释了这种差异。
