Breast Cancer in Women Aged 75 Years and Older

Objective: Breast cancer is the most common cancer in women, with incidence and mortality increasing dramatically with age. Applying data of younger patients to the geriatric age group indicates ‘‘evidence biased medicine’’. Therefore, this study aimed to present the clinical and pathological features of breast cancer and treatment choices in older patients. Materials and Methods: This study included 72 patients aged 75 years and older with breast cancer who were admitted to our medical oncology clinic between 2005 and 2013. Clinicopathological and demographic features, progression-free survival and overall survival and adjuvant and palliative treatments were recorded retrospectively. Categorical variables were presented as number (n) and percentage (%) and continuous variables as median and minimum-maximum. Survival curves were drawn using the Kaplan-Meier method. P<0.05 was considered as statistically significant. Results: The study population consisted of 72 patients, with a median age of 78 (minimum-maximum: 75-88). The most common pathological type of breast cancer was invasive ductal carcinoma, followed by infiltrative lobular carcinoma. Steroid receptor positivity rates were high, and the cerbB2 status was mostly negative; older patients had favourable tumours. Endocrine therapy was the most preferred option in this geriatric patient group, and aromatase inhibitors were the most commonly chosen hormonotherapy. Endocrine therapy is the first choice in palliative treatment; however, chemotherapy was preferred in second- and third-line treatment in metastatic diseases. Conclusion: According to available literature, geriatric patients show similarities in histologic and intrinsic subtypes with postmenopausal women, except for frailty and comorbidities. However, in geriatric patients, endocrine therapy is preferred as adjuvant and/or metastatic treatment because they are more susceptible to chemotherapeutic agents. Oncologists should consulate every older patient to geriatric medicine, and comprehensive geriatric assessment should be done to decide and continue treatment. Age should not be the only factor in decision-making.