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. 2019 Dec;178(3):693-701.
doi: 10.1007/s10549-019-05426-2. Epub 2019 Sep 6.

Optimal treatment of breast cancer in women older than 75 years: a Korea Breast Cancer Registry analysis

Ye Won Jeon  1 , Sun Hyong You  2 , Jong Eun Lee  3 , Hyun Jo Youn  4 , Woosung Lim  5 , Jai Hong Han  6 , Chan Heun Park  7 , Yong Seok Kim  8
Affiliations

Optimal treatment of breast cancer in women older than 75 years: a Korea Breast Cancer Registry analysis

Ye Won Jeon et al. Breast Cancer Res Treat. 2019 Dec.

Abstract

Purpose: The aim of this study was to investigate the therapeutic efficacy of adjuvant modalities for elderly Asian breast cancer patients using population-based data from the Korean Breast Cancer Registry database.

Methods: We identified 53,582 patients who underwent curative surgery between January 2005 and December 2010. The primary end point was the comparison of overall survival between the administration or omission of adjuvant treatment modalities, including endocrine treatment, radiation therapy, and chemotherapy, in the elderly group (older than 75 years) compared with the control group (younger than 75 years).

Results: Of the 53,582 patients analyzed, the total number of elderly patients was 901 (1.7%), and the number of control patients was 52,681 (98.3%). Although elderly patients were found to have larger tumor sizes (p = 0.024) and higher pathological stages (p < 0.001) than the control group, elderly patients were less likely to undergo adjuvant treatment compared to the control group. However, use of endocrine treatment in elderly patients with HR-positive breast cancer is associated with improved overall survival (OS) (adjusted OR 0.417; 95% confidence interval [CI] 0.240-0.726; p = 0.002). Furthermore, chemotherapy was associated with a significant improvement in OS in patients with stage II and III breast cancer (adjusted OR 0.657; 95% CI 0.462-0.934; p = 0.019).

Conclusion: Endocrine treatment and chemotherapy for elderly patients are associated with improved OS. Therefore, personalized decision-making based on the potential survival benefit of adjuvant treatment modalities should be made with the careful counseling of all elderly patients with breast cancer.

Keywords: Adjuvant treatment; Breast neoplasms; Elderly women; Survival.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Schematic diagram of the study
Fig. 2
Fig. 2
Overall survival of the control (< 75 years old) and the elderly (≥ 75 years old) groups by adjuvant modalities (hormonal therapy, radiation therapy and chemotherapy). a, c, e: control group; b, d, f: elderly group
See this image and copyright information in PMC

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