Older adults with a breast cancer diagnosis often undergo surgery, but fewer than 50% have adjuvant treatment with endocrine therapy, radiation therapy, or chemotherapy, according to findings from researchers with Morton Plant Mease Hospitals in Clearwater, FL, presented on Friday, December 9, at the San Antonio Breast Cancer Symposium.
The group used data from its registry of breast cancer diagnosed between 2005 and 2010, evaluating method of diagnosis (mammogram versus palpable abnormality), age at diagnosis, stage at diagnosis, type of surgery (breast-conserving therapy or mastectomy), receptor status (estrogen receptor, progesterone receptor, or human epidermal growth factor receptor 2), and treatments received (hormonal therapy, radiation therapy, or chemotherapy). They also reviewed average survival post-diagnosis, but data on causality of death was not readily available in the registry.
Over the course of the time frame, 495 cases of breast cancer were identified in women ranging in age from 81–102 years (median age = 85 years). Mammograms detected cancer in 55% of the women, and 41% of the cancers were detected by palpable abnormality. The majority of patients were diagnosed at stage 2 (45%) or stage 0 (12%). The majority (55%) underwent lumpectomy, and 31% underwent mastectomy. Only 4 of the 59 patients with HER2 data tested positive. A total of 34% underwent radiation, 6% underwent chemotherapy, 34% underwent hormone therapy, 2% underwent radiation and chemotherapy, 18% underwent radiation and hormone therapy, and 2% underwent chemotherapy and hormone therapy. A large percentage (41%) did not undergo any treatment. The median survival rate was 54 months, and the average survival was 56 months; with 203 patients alive after 5 years, the mortality rate in this cohort is about 62%, the researchers said. Table 1 shows comparative data among the age groups.
Table 1. Comparative Data Among Age Groups
| Age at Diagnosis | |||
| 80–84 | 85–89 | > 90 | |
| Number of patients | 244 | 192 | 56 |
| Mammogram | 138 | 105 | 32 |
| Palpable lump | 94 | 79 | 24 |
| Lumpectomy | 157 | 67 | 24 |
| Mastectomy | 80 | 30 | 26 |
| Average survival (months) | 84.5 | 48 | 48.5 |