Diagnosis, treatment characteristics, and survival of women with breast cancer aged 65 and above: a hospital-based retrospective study

BMC Womens Health. 2013 Aug 28;13:34. doi: 10.1186/1472-6874-13-34.

Abstract

Background: Breast cancer incidence in women increases with age, while survival rates decrease. Studies interpret this result as meaning higher comorbidity, diagnosis at later stages of the disease, and less effective treatment in the elderly. The aim of this study is to evaluate the diagnosis and treatment characteristics of breast cancer and their effect on the survival of women aged 65 and above.

Methods: The data within the files of 1064 women with breast cancer, who were followed-up in Dokuz Eylul University Medical Faculty Hospital between 2000 and 2006, were reviewed retrospectively. The survival probabilities at years 1 and 5 were calculated by life table analysis. The Kaplan-Meier test was used for calculating mean survival time, and the differences between groups were evaluated by log-rank test. The backward elimination method was used for multivariate analysis, and a -2 log-likelihood ratio was used for comparison of different models.

Results: Of the patients, 25.3% were aged 65 and above at the time of the diagnosis. Patients in this group had more comorbidities and were more likely to be diagnosed at advanced stages than younger patients. Additionally, they had lower rates of surgical treatment, chemotherapy or radiotherapy. One and 5-year survival probabilities among age groups were 96.1% and 84.5%, respectively, for <65 years, 93.5% and 84.8%, respectively, for 65-69, 98.7% and 84.0%, respectively, for 70-74, and 85.5% and 59.6%, respectively, for 75 years and above. In the multivariate model, age, clinical stage, and comorbidity were found to be negatively associated with the survival rate.

Conclusions: The survival of women with breast cancer aged 65 and above was affected negatively by age at diagnosis, clinical stage, and the presence of comorbidity. Early diagnosis also is very important for elderly women. Additionally, because of higher comorbidity, their evaluation and treatment should be planned by an interdisciplinary team.

MeSH terms

  • Age Factors
  • Aged
  • Breast Neoplasms / diagnosis*
  • Breast Neoplasms / mortality
  • Breast Neoplasms / therapy
  • Comorbidity
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Middle Aged
  • Multivariate Analysis
  • Prognosis
  • Proportional Hazards Models
  • Retrospective Studies
  • Treatment Outcome