Clinico-Pathological Features of Breast Cancer and Impact on Survival in Elderly Patients

Background: Breast carcinoma is one of the most commonly identified cancers 
in women worldwide, the 5th reason of cancer-related deaths and commonly 
affecting older Egyptian females.
Aim: To explore the clinical and pathological characteristics of breast cancer in 
elderly women and impact on survival.
Methods: A retrospective study was performed based on medical records of 
females who were treated in National Cancer Institute, Cairo University, 
Zagazig University Hospitals, and Meet-Ghamr Oncology Center in the period 
between January 2012 and December 2016. 
Results: The study included 343 breast cancer patients whose age ranging 
between 65 and 80 years with mean age 68.8 years. About 85.1% of the studied 
cases had no family history of breast carcinoma and 82.8% of them had negative 
history of taking oral contraceptive pills (OCP). Associated co-morbidities were 
noticed in 57.4% of this group. Our group tends to present with clinical stage II 
and III (44.8%), (34%) respectively, with lymph node involvement in (56.6%)
of cases and high percentage of hormone expression [ER-positive (79.6%), PRpositive (76.4%)] while lower frequency to be HER-2 positive (15.5%). Most of 
cases (88%) underwent upfront surgery, modified radical mastectomy (MRM) 
was the main procedure. The overall survival (OS) rate for the whole study 
group at 5 years was 70.7% with median OS 87.1 months, while the DFS rate at
5 years was 81.6% after exclusion of the 21 patients who had metastasis at 
diagnosis. Expression of ER and PR was related with better survival. 
Conclusion: Breast cancer in elderly patients in our study tends to be diagnosed 
at a later stage with best outcome with hormone receptor positive women and
further studies are needed to evaluate better management.