Tumor characteristics and clinical outcome of elderly women with breast cancer

Background: The number of elderly patients with breast cancer is increasing. Limited age-related information available about this disease prompted this study. Patients and Methods: The study population was derived from 50 828 and 256 287 patients with invasive breast cancer in San Antonio breast cancer databases and the Surveillance, Epidemiology, and End Results (SEER) registry, respectively. Tumor biologic and clinical characteristics, local and systemic therapies, and survival according to the patient's age were analyzed. Survival was also compared with that of age-matched women from the general population. Results: In patients 55 years old or older, there was an association between increasing age at diagnosis and the presence of more favorable biologic characteristics of the tumor, including more tumors that express steroid receptors, lower proliferative rates, diploidy, normal p53, and absence of the expression of epidermal growth factor receptor and c- erbB2. In older patients with lymph node-negative disease and/or small tumors, the observed and expected survivals were almost identical. In the SEER registry, the 8-year survival of lymph node-negative patients relative to the expected survival of age-matched women from the general population was 1.01 (95% confidence interval [CI] = 0.98-1.04) for patients 70-74 years old, 1.06 (95% CI = 1.01-1.11) for patients 75-79 years old, and 1.09 (95% CI = 0.98-1.20) for patients 80-84 years old. Conclusion: In women 55 years old or older, advancing age is associated with more favorable tumor biology, and breast cancer survival in older women is similar to survival in the general population irrespective of disease status. This favorable outcome should be considered when making clinical decisions in older patients.