Breast-conserving therapy in older patients with breast cancer over three decades: progress or stagnation

J Geriatr Oncol. 2019 Mar;10(2):330-336. doi: 10.1016/j.jgo.2018.08.007. Epub 2018 Aug 18.

Abstract

Background: The aim of this study was to analyze the distant metastases-free survival (DMFS), and disease-specific survival (DSS) after breast-conserving therapy (BCT) in older patients with breast cancer in a large, population-based, single-center cohort study with long-term follow-up.

Material and methods: Analyses were based on 1,425 women aged 65 years and older with breast cancer treated with BCT. Patients were divided in three age categories: 65 - 70 years, 71 - 75 years, and >75 years. The study period extended over 30 years, divided in three decades. Multivariate survival analysis was carried out using Cox regression analysis.

Results: The two youngest age categories showed significant improvements over time in 12-year DMFS and DSS. For women aged 65 - 70 years, this improvement was noted in stage I and stage II disease, while for women aged 71 - 75 years this was mainly in stage II tumors. Women >75 years of age did not show any improvement over time, regardless of stage.

Conclusion: Among older Dutch women with breast cancer, outcomes with regard to DMFS and DSS after BCT differ between various age categories, showing the least gain in the very old.

Keywords: Breast neoplasms; Breast-conserving therapy; Cohort study; Older adults; Survival analyses.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents, Hormonal / therapeutic use*
  • Axilla
  • Breast Neoplasms / mortality
  • Breast Neoplasms / pathology
  • Breast Neoplasms / therapy*
  • Carcinoma, Ductal, Breast / mortality
  • Carcinoma, Ductal, Breast / pathology
  • Carcinoma, Ductal, Breast / therapy*
  • Carcinoma, Lobular / mortality
  • Carcinoma, Lobular / pathology
  • Carcinoma, Lobular / therapy*
  • Chemotherapy, Adjuvant
  • Female
  • Humans
  • Longitudinal Studies
  • Lymph Node Excision
  • Margins of Excision
  • Mastectomy, Segmental*
  • Multivariate Analysis
  • Neoplasm Metastasis
  • Neoplasm Staging
  • Netherlands
  • Proportional Hazards Models
  • Prospective Studies
  • Radiation Dose Hypofractionation
  • Radiotherapy, Adjuvant / methods*
  • Sentinel Lymph Node Biopsy
  • Survival Analysis

Substances

  • Antineoplastic Agents, Hormonal