Breast cancer in elderly women (≥80 years): Variation in standard of care?

Objective: The study aim was to investigate the methods of breast cancer diagnosis and treatment for women at advanced ages. Methods: We identified 134 patients ≥80 years old treated for breast cancer. Data included patient and tumor characteristics, treatment, and outcomes. Results: Of 134 women ≥80 years old, 146 breast cancers were diagnosed. Sixty-five (45%) were detected by mammography. Surgical therapy included partial mastectomy in 50% and mastectomy in 50%. Although 12 (9%) women had no axillary staging, 22 (16%) underwent axillary lymph node dissection for node-negative disease. Of 73 patients undergoing partial mastectomy, 34 (47%) received adjuvant radiation. Of 113 cancers with known estrogen receptor (ER) status, 83% were ER positive; 95% received endocrine therapy. Fourteen (10%) received adjuvant chemotherapy. Eleven (8%) were Her-2neu-amplified; one patient received adjuvant trastuzumab. At follow-up, 87 (65%) patients were alive without evidence of disease, while 6 (4%) died of breast cancer. Conclusions: Breast cancer in women ≥80 years is more likely to be early-stage with favorable tumor biology. While most women eligible for antiestrogen therapy received it, adjuvant radiation, chemotherapy, and/or trastuzumab were utilized infrequently. Despite these variations, older women with breast cancer are unlikely to suffer breast cancer-related mortality.