Surgical treatment of breast cancer in patients aged 80 years or older - how much is enough?
Menée à partir des données de registres médicaux portant sur 154 patientes âgées de 80 ans ou plus et atteintes d'un cancer du sein de stade précoce traité par chirurgie entre 2000 et 2008 (durée médiane de suivi : 5,3 ans), cette étude identifie les facteurs clinicopathologiques associés à la survie spécifique, puis détermine le traitement chirurgical le plus approprié pour ces patientes
Background : The population of elderly people is increasing and so is the population of breast cancer patients aged >=80 years. The aim of our retrospective study was to identify independent prognostic factors for the duration of breast cancer-specific survival of surgically treated patients aged >=80 years. The secondary aim was to determine the appropriate surgical treatment of breast cancer in patients aged >=80 years. Methods : We reviewed the medical records of 154 patients aged >=80 years with early-stage breast cancer (mean age 83 years) who underwent surgery at the tertiary cancer center in the period from 2000 to 2008. Tumor stage was pT1/pT2 and pT3/pT4 in 75% and 25%, respectively. Surgical treatment comprised: quadrantectomy (in 27%), mastectomy (in 73%), axillary dissection (in 57%), and sentinel lymph node biopsy (in 18%), while 25% of patients had no axillary surgery. Results : During a median follow-up of 5.3 years, 31% of patients died of breast cancer, while 28% of patients died of other causes. Half of our patients with poorly differentiated breast cancer or estrogen receptor-negative tumor died of breast cancer. Multivariate statistical analysis showed that the pathological T-stage, pathological N-stage and estrogen receptors were independent prognostic factors for the duration of breast cancer-specific survival of patients. Conclusion : Short breast cancer-specific survival indicates that, in patients aged >=80 years, breast cancer with metastases in axillary lymph nodes can be an aggressive disease.