The treatment of breast cancer in the elderly: a community hospital experience.

The physician's dilemma in choosing the optimal management for breast cancer in the elderly arises from long-held beliefs that elderly patients 1) have a limited life expectancy from comorbid conditions other than breast cancer and 2) do not tolerate standard treatment. To determine if these beliefs were indeed reflective of the clinical behavior of breast cancer in the elderly, we reviewed the hospital and tumor registry records of 182 women age 70 years and older who received treatment for locoregional invasive breast cancer (Stage I and II) at CAMC between 1977 and 1987. The median time interval between diagnosis and last contact or death was 82 months. Actuarial survival was calculated on the basis of this interval Statistical Analysis System (SAS). Eighty-five percent of patients underwent mastectomy and 15% had breast conservation surgery. There was only one postoperative death. Forty-eight (26%) of 182 patients received systemic adjuvant therapy. The breast cancer-specific survival rate of all patients in this study was 84% at five years and 71% at 10 years. The 5-year and 10-year breast cancer specific survivals were 94% and 86% for stage I patients respectively and for stage II patients the five-year and 10-year survivals were 74% and 56% respectively. Our results indicate that the majority of elderly women with breast cancer can tolerate standard surgical therapy and survive disease-free for many years.