Explore The Clinicopathological Features Of Breast Cancer In Elderly Women And Clinical Analysis Of Breast Conserving Therapy In Elderly Patients

Objective:To investigate the clinicopathological features treatment and survival factors in female breast cancer patients over65years old and to analysis the management of breast conserving therapy in the elderly.Methods:A total of445breast cancer patients over65years old between January2003to December2005and55breast cancer patients treated with breast conserving therapy over65years old,55early stage breast cancer patients treated with modified radical mastectomy over65years old,55breast cancer patients treated with breast conserving therapy between40to64years old and55breast cancer patients treated with breast conserving therapy under40years old between January2003to December2008in Tianjin Medical University Cancer Hospital were retrospectively reviewed. The clinicopathological and treatment of elderly patients were concluded and analyzed by statistical soft ware SPSS19.0. The clinical data were described by the percentage and compared by chi-square test, Kaplan-Meier method for calculation of survival, Log-Rank method for the univariate factor analysis, COX model for multivariate factors analysis, with p<0.05defined as a statistically significant difference.Results:1. Of all the445breast cancer patients over65years old,96%patients presented breast lump as initial symptom,80%patients associated with other diseases,87%patients’ tumor size were smaller than5centimeter,58%patients have no metastasis lymph node,80%patients belong to early stage. Immunohistochemical analysis revealed ER/PR-positive rate was68%, HER2-positive rate was18%, the most common molecular typing was Luminal A.2. Of all the445elderly breast cancer patients, the3-year,5-year,10-year overall survival was90.3%、84.5%、67.0%, the3-year,5-year,10-year disease free survival was84.2%、80.1%、64.4%.3. The5-year overall survival of patients with breast conserving therapy and modified radical mastectomy was95.6%and96.4%(p>0.05) respectively and the5-year disease free survival was92.0%and92.6%(p>0.05) respectively, with no difference in clinicopathological futures and treatment.4. The5-year overall survival of patients with breast conserving therapy between elderly,40to64years old and under40years old was97.4%,100%,98.1%(p>0.05) respectively and5-year disease free survival was96.2%,98.1%,93.7%(p>0.05) respectively, with younger patients had lower clinical stage and more chemotherapy and radiotherapy.5. All of the55elderly patients with breast conserving therapy were belong to early stage including stage Ⅰ and Ⅱ. Lymph node metastasis and radiotherapy were related with local recurrence and metastasis(p<0.05).Conclusions:1. Elderly breast cancer patients have better prognosis with more lower stage tumors and higher percentage molecular typing of Luminal A.2. Tumor size and lymph node metastasis were independent prognostic factors of survival for elderly patients.3. There is no difference of survival in elderly patients treated with breast conserving therapy and modified radical mastectomy.4. There is no difference of survival in elderly and younger patients treated with breast conserving therapy.5. Lymph node metastasis and radiotherapy were prognostic factors of local recurrence and metastasis in elderly patients treated with breast conserving therapy.