Comparison of the Beneficial Effects of Adjuvant Chemotherapy among Young and Old Aged Breast Cancer Patients
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Purpose: Breast cancer rates are expected to rise with an increasingly aging society. However, research on breast cancer among elderly women is scarce. In the present study, we aimed to investigate the clinicopathological features of elderly women with breast cancer and assess their clinical outcomes following adjuvant chemotherapy. Methods: Patients who underwent curative surgery for breast cancer between January 1, 2009 and December 31, 2014 were retrospectively reviewed (n=1,865). The clinicopathological features, comorbidities, and survival outcomes were compared among three age groups (<55, 55–64, and ≥65 years). Subgroup analyses were also performed according to adjuvant chemotherapy status (i.e., administered or forgone) and need. Results: The median age of the patients (n=1,865) was 51.7 years, and 231 (12.3%) patients were ≥65 years of age (defined as elderly). The median follow-up period was 56 months. The tumor characteristics were similar among the three age groups, except for tumor size and progesterone receptor status. The five-year overall survival rate was significantly poorer in elderly patients (87.5%) than in the younger groups (<55 years: 94.1%; 55–64 years: 93.2%) (p=0.002). Elderly patients received significantly less frequent adjuvant chemotherapy than the younger patients (p<0.001). Not all elderly patients in need of adjuvant chemotherapy were administered chemotherapy. Those administered adjuvant chemotherapy had significantly higher five-year overall survival rates than that of the non-administered patients (86.5% vs. 66.5%, p=0.014) and marginally longer breast cancer-specific survival (87.9% vs. 73.5%, p=0.07). Elderly patients who did not undergo chemotherapy had a higher prevalence of diabetes mellitus than those who did. Conclusion: Adjuvant chemotherapy in elderly breast cancer patients improved overall survival, and marginally extended breast cancer-specific survival. Therefore, standard adjuvant chemotherapy should be considered in elderly patients who require it.
Abstract
Purpose: Breast cancer rates are expected to rise with an increasingly aging society. However, research on breast cancer among elderly women is scarce. In the present study, we aimed to investigate the clinicopathological features of elderly women with breast cancer and assess their clinical outcomes following adjuvant chemotherapy. Methods: Patients who underwent curative surgery for breast cancer between January 1, 2009 and December 31, 2014 were retrospectively reviewed (n=1,865). The clinicopathological features, comorbidities, and survival outcomes were compared among three age groups (<55, 55–64, and ≥65 years). Subgroup analyses were also performed according to adjuvant chemotherapy status (i.e., administered or forgone) and need. Results: The median age of the patients (n=1,865) was 51.7 years, and 231 (12.3%) patients were ≥65 years of age (defined as elderly). The median follow-up period was 56 months. The tumor characteristics were similar among the three age groups, except for tumor size and progesterone receptor status. The five-year overall survival rate was significantly poorer in elderly patients (87.5%) than in the younger groups (<55 years: 94.1%; 55–64 years: 93.2%) (p=0.002). Elderly patients received significantly less frequent adjuvant chemotherapy than the younger patients (p<0.001). Not all elderly patients in need of adjuvant chemotherapy were administered chemotherapy. Those administered adjuvant chemotherapy had significantly higher five-year overall survival rates than that of the non-administered patients (86.5% vs. 66.5%, p=0.014) and marginally longer breast cancer-specific survival (87.9% vs. 73.5%, p=0.07). Elderly patients who did not undergo chemotherapy had a higher prevalence of diabetes mellitus than those who did. Conclusion: Adjuvant chemotherapy in elderly breast cancer patients improved overall survival, and marginally extended breast cancer-specific survival. Therefore, standard adjuvant chemotherapy should be considered in elderly patients who require it.
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