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J Geriatr Oncol. 2013 Jan;4(1):39-47. doi: 10.1016/j.jgo.2012.08.002. Epub 2012 Aug 24.

Treatment of breast cancer in the elderly: a prospective, population-based Swiss study.

Author information

1
Cancer Registry St. Gallen-Appenzell, St.Gallen, Switzerland; Department of Medical Oncology, Cantonal Hospital, St. Gallen, Switzerland. Electronic address: markus.joerger@kssg.ch.

Abstract

OBJECTIVES:

The primary objective of this population-based study is to describe the patterns of care of elderly patients with breast cancer (BC), and evaluate potential causative factors for the decrease in BC-specific survival (BCSS) in the elderly.

PATIENTS AND METHODS:

We included all or representative samples of patients with newly diagnosed BC from seven Swiss cancer registries between 2003 and 2005 (n=4820). Surgical and non-surgical BC treatment was analyzed over 5 age groups (<65, 65 to <70, 70 to <75, 75 to <80 and ≥80years), and the predictive impact of patient age on specific treatments was calculated using multivariate logistic regression analysis.

RESULTS:

The proportion of locally advanced, metastatic and incompletely staged BC increased with age. The odds ratio for performing breast-conserving surgery (BCS) in stages I-II BC (0.37), sentinel lymph node dissection (SLND) in patients with no palpable adenopathy (0.58), post-BCS radiotherapy (0.04) and adjuvant endocrine treatment (0.23) were all in disfavor of patients ≥80years of age compared to their younger peers. Only 36% of patients ≥80years of age with no palpable adenopathy underwent SLND. In the adjusted model, higher age was a significant risk factor for omitting post-BCS radiotherapy, SLND and adjuvant endocrine treatment.

CONCLUSIONS:

This study found an increase in incomplete diagnostic assessment, and a substantial underuse of BCS, post-BCS radiotherapy, SLND and adjuvant endocrine treatment in elderly patients with BC. There is a need for improved management of early BC in the elderly even in a system with universal access to health care services.

PMID:
24071491
DOI:
10.1016/j.jgo.2012.08.002
[Indexed for MEDLINE]

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