%0 Journal Article
%T Undertreated Breast Cancer in the Elderly
%A Manmeet Kaur Malik
%A Paul Ian Tartter
%A Rachel Belfer
%J Journal of Cancer Epidemiology
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/893104
%X The effect of undertreatment with adjuvant hormonal therapy, chemotherapy, or radiation was studied in elderly women with breast cancer. A prospectively maintained database was used to identify women undergoing potentially curative surgery between 1978 and 2012. The presentation, pathologic findings, treatment, and outcomes of 382 women over 70 were compared to the findings in 2065 younger patients. Subsequently, conventionally treated and undertreated elderly patients were identified and their characteristics and outcomes were compared. Both young and old patients presented most frequently with mammographic findings, but older patients presented more frequently with mammographic masses while younger patients presented more frequently with mammographic calcifications. Cancers of older patients were significantly more favorable than cancers in younger patients: smaller, with more infiltrating lobular, fewer ductal carcinoma in situ, and more frequently estrogen receptor positive and fewer were poorly differentiated. Elderly patients had less axillary sampling, fewer mastectomies, less adjuvant radiation therapy, and more hormonal therapy. Fifty-one percent of the 382 elderly patients were undertreated by conventional criteria. Undertreated patients were more frequently in situ, better differentiated, smaller, and more often estrogen receptor positive. Forty-four percent of the undertreated patients died during followup without disease recurrence. Despite undertreatment, local and distant disease-free survival was comparable to patients who were not undertreated. 1. Introduction The population of elderly individuals in the United States is increasing. Between 2000 and 2010 the population of women aged 65 and over increased by 11.3% with those 70 and over increasing by 6.4% [1]. According to the Surveillance Epidemiology and End Results (SEERs) database, from 2000 to 2009 the median age for breast cancer diagnoses in the USA was 61 years of age. Approximately 41% were diagnosed above the age of 65, of which 21% were above the age of 75 [2]. As the USA population of women over 65 increases, breast cancer in older individuals has and will continue to become more prevalent. The management of breast cancer in the elderly has been a topic of debate. There is a lack of evidence on the optimal management of this group of patients secondary to low enrollment in randomized clinical trials [3, 4]. As a result, treatment decisions have been largely based on studies in younger patients which may not be applicable to elderly patients with breast cancer. Breast cancers
%U http://www.hindawi.com/journals/jce/2013/893104/