Clinicopathological Characteristics And Prognostic Factors Of Breast Cancer In Older Women

Objective: The aims of this study are to describe tumor clinicopathological characteristics and treatment patterns of elderly female breast cancer patients,to compare the characteristics with research abroad and in china,and to determine the factors influencing prognosis,Provide theoretical basis for personal treatments scheme fit for Chinese older female breast cancer patients.Methods:1 This retrospective cohort included 1144 patients(?65)of primary breast cancer women diagnosed and treated in 4th Hospital of Hebei Medical University from Jan 2009 to Dec 2015.The patients were divided into two age groups: 65-70 years old group and>70 years old group.The clinicopathological characteristics?treatment patterns and prognosis were compared by different age groups.We followed up 382 patients diagnosed and treated in4 th Hospital of Hebei Medical University from Jan 2009 to Dec 2011.The overall survival(OS)and disease free survival(DFS)were used to assess the prognosis of elderly female breast cancer patients.2 Statistical analyses were performed by SPSS 21.0 software.The chi-square test and Fisher exact test were used to compare the differences between two age groups.The Kaplan-Meier survival curve was analyzed by univariate survival analysis,and the COX regression model was used for multivariate survival analysis.All statistical tests were considered significant at P<0.05.Results:1 Elderly breast cancer Patients presented most frequently with palpable mass(94.2%).The most frequent pathological pattern was invasive ductal carcinoma,other ptterns with good prognosis like invasive lobular carcinomaor mucinous carcinoma were relatively more.Elderly women had lager tumors at diagnosis with more T1 and T2 pathological stage.The percentage of lymph node metastasis was 37.8%,and most patients had 1-3 lymph node metastasis.The elderly breast cancer patients had biological type of good prognosis.The positivity of ER and PR were 71.9% and 63.3%.The positivity of Ki-67 and HER-2 expression was low,Tumors had better differentiation.2 Surgery was the most important treatment of elderly breast cancer patients.They were more likely to receive modified radical mastectomy,and less likely to receive breast conserving surgery compared with younger and foreigner patients.Patients received less chemistry radiotherapy and more endocrine therapy.3 382 patients had complete following-up data.After median follow-up of 64 months,the five-year overall survival rate was 86.6%,64 cases died and41 cases died from breast cancer.The five-year disease free survival rate was86.6%,74 cases had local recurrence or distant metastasis.Age and tumor size were the independent prognostic factors for OS.Tumor size was the independent prognostic factor for DFS.Conclusion: The elderly breast cancer patients had pathological and biological type of good prognosis.They were more likely to receive surgery and endocrine therapy,and less likely to receive chemistry and radiotherapy.Age and tumor size were the independent prognostic factors for OS.>70years old group had better five-year overall survival rate than 65-70 years old group.