Surgery improves breast cancer-specific survival in octogenarians with early-stage breast cancer

Abstract

Introduction: No consensus exists on optimum therapy for older cancer patients. This singlecentre study was conducted to review the treatment and outcomes for octogenarian women treated for breast cancer.

Methods: Data of all elderly breast cancer patients (≥80 years) with primary breast cancer treated at out institution between 1990 and 2009. Patients with carcinoma in-situ (stage 0) and advanced breast cancer (stage IV) were excluded. Breast cancer-specific survival and disease-free survival for the different patient groups were analysed according to the Kaplan-Meier method.

Results: The study population consisted of 259 patients (median age 84 years). There were 189 (73%) patients with early stage disease (I, IIA, IIB) and 70 (27%) with locally advanced disease (IIIA, IIIB, IIIC). A total of 175 (67.7%) patients underwent surgical treatment and 84 (32.4%) received primary endocrine treatment. Patients were followed for a median of 65 months. In patients with early stages, the mean breast cancer-specific survival was 108 months (95% CI 101-115) in the surgical group and 50 months (95% CI 39-61) in the non-surgical group (P < 0.01), whereas patients with locally advanced breast cancer breast cancer-specific survival was similar for the surgical and non-surgical groups. Breast cancer-specific survival and disease-free survival were significantly better among patients who underwent standard surgical treatment than among those with suboptimal surgery.

Conclusion: In women ≥80 years with early-stage breast cancer, standard surgical treatment as compared with non-surgical therapy was associated with a better breast cancer-specific.

Keywords: Breast cancer; Breast cancer-specific survival; Octogenarian patients; Primary endocrine therapy; Standard surgical treatment.