Singletary S E, Shallenberger R, Guinee V F
Department of General Surgery, University of Texas M. D. Anderson Cancer Center, Houston 77030.
Ann Surg. 1993 Nov;218(5):667-71. doi: 10.1097/00000658-199321850-00013.
OBJECTIVE/METHODS: To determine the clinical behavior and outcome of breast cancer in the elderly, a series of 184 women older than age 69 years who received treatment for locoregional breast cancer at The University of Texas M. D. Anderson Cancer Center between 1976 and 1985 were studied for a median of 80 months.
The results indicate that elderly women can tolerate standard surgical therapy and survive disease-free for many years; the breast cancer-specific survival rate of patients in this study was 79% at 7 years. Although 33% of patients had stage I disease, only 10% underwent breast conservation surgery. Despite 46% of patients having stage II and 21% having stage III breast cancer, fewer than 13% received systemic adjuvant therapy. Noncompliance with breast screening guidelines was evident in that only 3% of patients had tumors detected by routine screening mammograms and only 12% by routine physical examinations.
Women with breast cancer should be informed of treatment options and the advantages and disadvantages of each choice based on physiologic rather than chronologic age.
目的/方法：为了确定老年乳腺癌患者的临床行为和预后，我们对1976年至1985年间在德克萨斯大学MD安德森癌症中心接受局部区域乳腺癌治疗的184名69岁以上女性进行了研究，研究中位时间为80个月。
结果表明，老年女性能够耐受标准手术治疗并多年无病生存；本研究患者的乳腺癌特异性生存率在7年时为79%。尽管33%的患者为I期疾病，但只有10%的患者接受了保乳手术。尽管46%的患者为II期乳腺癌，21%为III期乳腺癌，但接受全身辅助治疗的患者不到13%。不遵守乳腺癌筛查指南的情况很明显，因为只有3%的患者通过常规筛查乳房X光检查发现肿瘤，只有12%的患者通过常规体格检查发现肿瘤。
应根据生理年龄而非实际年龄，向乳腺癌患者告知治疗选择以及每种选择的优缺点。
