Management of Breast Cancer in Geriatric Patients

DATE PUBLISHED
October 11, 2019
SECTION
Articles

Abstract

Introduction: We aimed to evaluate the diagnosis and treatment of breast cancer in women over 70 years.

Material & Methods: Patients who were operated due to breast cancer between January 2012 and January 2015 evaluated retrospectively. Patients were classified as Group 1 with patients aged 70 and over and Group 2 with patients under 70 years of age. For statistical analyses, χ2 and Mann–Whitney U tests were underwent (P<0.05).

Results: The study included 381 patients. Comorbidities were found in 156 patients. Of the patients, 53 aged 70 years and over (Group 1) and 328 under 70 years (Group 2). 48 patients of Group 1 and 143 patients of Group 2 underwent mastectomy and 5 patients of Group 1 and 185 patients of Group 2 underwent breast conserving surgery (P<0.0001).

Estrogen receptor was positive in 51 patients of Group 1 and in 313 patients of Group 2 (P= 0.79). The mean follow-up duration was 46 months. During follow-up, local or systemic metastasis or recurrence and mortality occurred in 4 and 2 patients in Group 1 and in 10 and 5 patient in Group 2, respectively.

Discussion: Age-related, breast cancer risk factors may also change. Treatment should be determined considering tumor characteristics and comorbidities in elderly patients with breast cancer. Thus, clinically, treatment strategies can be better identified. Surgical and oncologic treatment approaches do not differ in geriatric patients. Treatment options as well as surgical, chemotherapy and radiotherapy should be planned considering the patient's wishes, general condition and comorbidities.

Keywords

Geriatrics, Breast cancer, Treatment.

References

Karuturi M, VanderWalde N, Muss H. Approach and Management of Breast Cancer in the Elderly. Clin Geriatr Med 2016;32:133-53.

Biganzoli L, Wildiers H, Oakman C, Marotti L, Loibl S, Kunkler, et al. Management of elderly patients with breast cancer: updated recommendations of the International Society of Geriatric Oncology (SIOG) and European Society of Breast Cancer Specialists (EUSOMA) Lancet Oncol 2012;13:148–60.

Wildiers H, Kunkler I, Biganzoli L, Fracheboud J, Vlastos G, Bernard-Marty C, et al. Management of breast cancer in elderly individuals: recommendations of the International Society of Geriatric Oncology. Lancet Oncol 2007;8:1101–15.

Wildiers H, Heeren P, Puts M, Topinkova E, Janssen-Heijnen ML, Extermann M, et al. International Society of Geriatric Oncology consensus on geriatric assessment in older patients with cancer. J Clin Oncol 2014;32:2595–603.

Gosain R, Pollock Y, Jain D. Age-related Disparity: Breast Cancer in the Elderly. Curr Oncol Rep 2016;18:69.

Hansen TM, Zellars RC. Treatment Minimization in Older Patients With Early-Stage Breast Cancer. Cancer J 2017;23:231-7.

National Cancer Institute Surveillance. Epidemiology and End Results: Breast cancer incidence and mortality.

http://seer.cancer.gov/statfacts/html/breast.html.

Ries LA, Eisner MP, Kosary CL. SEER Cancer Statistics Review 1973–1999. Bethesda, Md, USA: National Cancer Institute; 2009.

Berrut G, de Decker L. Cancer screening in the elderly?. Geriatr Psychol Neuropsychiatr Vieil 2015;13:121.

Eda Elverici, Ayse Nurdan Barca, Arife Polat Duzgun, Levent Araz, Enis Yuksel, Faruk Coskun. Turkish Journal of Geriatrics 2007;10:1-4.

Kiderlen M, van de Velde CJH, Liefers GJ. FOCUS study group. Targeted therapy in older women with breast cancer - What's the target?. Eur J Surg Oncol 2017;43:944-8.

Jacob L, Hadji P, Kostev K. Age-related differences in persistence in women with breast cancer treated with tamoxifen or aromatase inhibitors in Germany. J Geriatr Oncol 2016;7:169-75.

Meresse M, Bouhnik AD, Bendiane MK, Retornaz F, Rousseau F, Rey D, et al. Chemotherapy in Old Women with Breast Cancer: Is Age Still a Predictor for Under Treatment? Breast J 2017;23:256-66.

Mariano C, Lund JL, Peacock Hinton S, Htoo P, Muss H, Reeder-Hayes KE. Evaluating the association between adjuvant chemotherapy and function-related adverse events among older patients with early stage breast cancer. J Geriatr Oncol 2017;8:242-8.

Extermann M, Leeuwenburgh C, Samiian L, Sehovic M, Xu J, Cubitt C. Impact of chemotherapy on medium-term physical function and activity of older breast cancer survivors, and associated biomarkers. J Geriatr Oncol 2017;8:69-75.

Author Details

Tolga Canbak

  • Health Science University, Umraniye Education and Research Hospital, Department of General Surgery, Istanbul, Turkey
  • Google Scholar
  • RAJAR Journal

Aylin Acar

  • Health Science University, Umraniye Education and Research Hospital, Department of General Surgery, Istanbul, Turkey
  • Google Scholar
  • RAJAR Journal

Huseyin Kerem Tolan

  • Health Science University, Umraniye Education and Research Hospital, Department of General Surgery, Istanbul, Turkey
  • Google Scholar
  • RAJAR Journal

Mustafa Ozbagriacik

  • Health Science University, Umraniye Education and Research Hospital, Department of General Surgery, Istanbul, Turkey
  • Google Scholar
  • RAJAR Journal

Prof. Fikret Ezberci

  • Health Science University, Umraniye Education and Research Hospital, Department of General Surgery, Istanbul, Turkey
  • Google Scholar
  • RAJAR Journal