Skip to main content
Annals of Surgery logoLink to Annals of Surgery
. 1993 Nov;218(5):667–671. doi: 10.1097/00000658-199321850-00013

Breast cancer in the elderly.

S E Singletary 1, R Shallenberger 1, V F Guinee 1
PMCID: PMC1243039  PMID: 8239782

Abstract

OBJECTIVE/METHODS: To determine the clinical behavior and outcome of breast cancer in the elderly, a series of 184 women older than age 69 years who received treatment for locoregional breast cancer at The University of Texas M. D. Anderson Cancer Center between 1976 and 1985 were studied for a median of 80 months. RESULTS: The results indicate that elderly women can tolerate standard surgical therapy and survive disease-free for many years; the breast cancer-specific survival rate of patients in this study was 79% at 7 years. Although 33% of patients had stage I disease, only 10% underwent breast conservation surgery. Despite 46% of patients having stage II and 21% having stage III breast cancer, fewer than 13% received systemic adjuvant therapy. Noncompliance with breast screening guidelines was evident in that only 3% of patients had tumors detected by routine screening mammograms and only 12% by routine physical examinations. CONCLUSIONS: Women with breast cancer should be informed of treatment options and the advantages and disadvantages of each choice based on physiologic rather than chronologic age.

Full text

PDF
669

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Adami H. O., Graffman S., Lindgren A., Sällström J. Prognostic implication of estrogen receptor content in breast cancer. Breast Cancer Res Treat. 1985;5(3):293–300. doi: 10.1007/BF01806024. [DOI] [PubMed] [Google Scholar]
  2. Akhtar S. S., Allan S. G., Rodger A., Chetty U. D., Smyth J. F., Leonard R. C. A 10-year experience of tamoxifen as primary treatment of breast cancer in 100 elderly and frail patients. Eur J Surg Oncol. 1991 Feb;17(1):30–35. [PubMed] [Google Scholar]
  3. Bates T., Riley D. L., Houghton J., Fallowfield L., Baum M. Breast cancer in elderly women: a Cancer Research Campaign trial comparing treatment with tamoxifen and optimal surgery with tamoxifen alone. The Elderly Breast Cancer Working Party. Br J Surg. 1991 May;78(5):591–594. doi: 10.1002/bjs.1800780523. [DOI] [PubMed] [Google Scholar]
  4. Bradbeer J. W., Kyngdon J. Primary treatment of breast cancer in elderly women with Tamoxifen. Clin Oncol. 1983 Mar;9(1):31–34. [PubMed] [Google Scholar]
  5. Chu J., Diehr P., Feigl P., Glaefke G., Begg C., Glicksman A., Ford L. The effect of age on the care of women with breast cancer in community hospitals. J Gerontol. 1987 Mar;42(2):185–190. doi: 10.1093/geronj/42.2.185. [DOI] [PubMed] [Google Scholar]
  6. Davis S. J., Karrer F. W., Moor B. J., Rose S. G., Eakins G. Characteristics of breast cancer in women over 80 years of age. Am J Surg. 1985 Dec;150(6):655–658. doi: 10.1016/0002-9610(85)90401-5. [DOI] [PubMed] [Google Scholar]
  7. Fisher B., Bauer M., Margolese R., Poisson R., Pilch Y., Redmond C., Fisher E., Wolmark N., Deutsch M., Montague E. Five-year results of a randomized clinical trial comparing total mastectomy and segmental mastectomy with or without radiation in the treatment of breast cancer. N Engl J Med. 1985 Mar 14;312(11):665–673. doi: 10.1056/NEJM198503143121101. [DOI] [PubMed] [Google Scholar]
  8. Fisher B., Redmond C., Poisson R., Margolese R., Wolmark N., Wickerham L., Fisher E., Deutsch M., Caplan R., Pilch Y. Eight-year results of a randomized clinical trial comparing total mastectomy and lumpectomy with or without irradiation in the treatment of breast cancer. N Engl J Med. 1989 Mar 30;320(13):822–828. doi: 10.1056/NEJM198903303201302. [DOI] [PubMed] [Google Scholar]
  9. Gazet J. C., Markopoulos C., Ford H. T., Coombes R. C., Bland J. M., Dixon R. C. Prospective randomised trial of tamoxifen versus surgery in elderly patients with breast cancer. Lancet. 1988 Mar 26;1(8587):679–681. doi: 10.1016/s0140-6736(88)91478-x. [DOI] [PubMed] [Google Scholar]
  10. Gelman R. S., Taylor S. G., 4th Cyclophosphamide, methotrexate, and 5-fluorouracil chemotherapy in women more than 65 years old with advanced breast cancer: the elimination of age trends in toxicity by using doses based on creatinine clearance. J Clin Oncol. 1984 Dec;2(12):1404–1413. doi: 10.1200/JCO.1984.2.12.1404. [DOI] [PubMed] [Google Scholar]
  11. Herbsman H., Feldman J., Seldera J., Gardner B., Alfonso A. E. Survival following breast cancer surgery in the elderly. Cancer. 1981 May 15;47(10):2358–2363. doi: 10.1002/1097-0142(19810515)47:10<2358::aid-cncr2820471006>3.0.co;2-k. [DOI] [PubMed] [Google Scholar]
  12. Horobin J. M., Preece P. E., Dewar J. A., Wood R. A., Cuschieri A. Long-term follow-up of elderly patients with locoregional breast cancer treated with tamoxifen only. Br J Surg. 1991 Feb;78(2):213–217. doi: 10.1002/bjs.1800780228. [DOI] [PubMed] [Google Scholar]
  13. Hunt K. E., Fry D. E., Bland K. I. Breast carcinoma in the elderly patient: an assessment of operative risk, morbidity and mortality. Am J Surg. 1980 Sep;140(3):339–342. doi: 10.1016/0002-9610(80)90163-4. [DOI] [PubMed] [Google Scholar]
  14. Makuc D. M., Freid V. M., Kleinman J. C. National trends in the use of preventive health care by women. Am J Public Health. 1989 Jan;79(1):21–26. doi: 10.2105/ajph.79.1.21. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Mueller C. B., Ames F., Anderson G. D. Breast cancer in 3,558 women: age as a significant determinant in the rate of dying and causes of death. Surgery. 1978 Feb;83(2):123–132. [PubMed] [Google Scholar]
  16. Qazi R., Chuang J. L., Drobyski W. Estrogen receptors and the pattern of relapse in breast cancer. Arch Intern Med. 1984 Dec;144(12):2365–2367. [PubMed] [Google Scholar]
  17. Robertson J. F., Todd J. H., Ellis I. O., Elston C. W., Blamey R. W. Comparison of mastectomy with tamoxifen for treating elderly patients with operable breast cancer. BMJ. 1988 Aug 20;297(6647):511–514. doi: 10.1136/bmj.297.6647.511. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Turnbull A. D., Gundy E., Howland W. S., Beattie E. J., Jr Surgical mortality among the elderly. An analysis of 4,050 operations (1970-1974). Clin Bull. 1978;8(4):139–142. [PubMed] [Google Scholar]
  19. Veronesi U., Salvadori B., Luini A., Banfi A., Zucali R., Del Vecchio M., Saccozzi R., Beretta E., Boracchi P., Farante G. Conservative treatment of early breast cancer. Long-term results of 1232 cases treated with quadrantectomy, axillary dissection, and radiotherapy. Ann Surg. 1990 Mar;211(3):250–259. [PMC free article] [PubMed] [Google Scholar]
  20. von Rosen A., Gardelin A., Auer G. Assessment of malignancy potential in mammary carcinoma in elderly patients. Am J Clin Oncol. 1987 Feb;10(1):61–64. doi: 10.1097/00000421-198702000-00014. [DOI] [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES