Primary breast cancer in older Chinese women as compared to their younger counterparts

Abstract

Background: This study aims to investigate the treatment, tumor biology and survival of breast cancer in elderly Chinese patients. A comparison was made with their younger counterparts. Methods: A retrospective study of patients with breast cancer who have undergone surgery in a university hospital from January 2001 to December 2009 was performed. Treatment options, tumor characteristics and survival of patients aged 70 and above were compared with those aged below 70. Results: 2826 Chinese patients with breast cancer underwent surgery during the study period. 394 patients (14%) were aged 70 and above, and 2432 patients (86%) were aged below 70. More elderly patients had astectomy than breast conservation (p < 0.0005). Less elderly patients received chemotherapy and radiotherapy (p < 0.0005). The use of hormonal therapy was similar between the two groups. Breast cancer in older women were of better histological grading (P < 0.0005), more estrogen receptor positive (p = 0.03) and less HER-2 oncogene overexpression (p = 0.016). The overall median survival for elderly patients was 5.27 years, which is worse than their younger counterparts (6.48 years; p < 0.0005), whereas the breast cancer specific survival were comparable between these two age groups. Discussion: Older Chinese women with breast cancer received less aggressive treatment. Despite this, the breast cancer specific survival in this older age group women was similar to that of their younger counterparts. This may be attributed to the better tumor prognostic indexes. The overall survival in elderly patients was worse, which may be explained by the presence of other non-cancer related causes of death.