Abstract　No 3065
| Breast
cancer in elderly women: Features of disease presentation and choice
of adjuvant therapies compared with younger postmenopausal patients
Category: Cancer in Older Patients Authors: G. Curigliano, R. Gennari, N. Rotmensz, M. Colleoni, G. Renne, L. Orlando, F. De Braud, C. Leonardi, P. Veronesi, A. Goldhirsch; European Institute of Oncology, Department of Medicine, Milano, Italy; Division of Senology, Milano, Italy; Division of Epidemiology, Milano, Italy; Department of Medicine, Milano, Italy; Division of Pathology, Milano, Italy; Division of Radiotherapy, Milano, Italy; Division of Senology, Milan, Italy Abstract: Breast cancer in elderly women: Features of disease presentation and choice of adjuvant therapies compared with younger postmenopausal patients.Category: Cancer in Older PatientsAuthor(s): G. Curigliano, R. Gennari, N. Rotmensz, M. Colleoni, G. Renne, L. Orlando, F. De Braud, C. Leonardi, P. Veronesi, A. Goldhirsch; European Institute of Oncology, Department of Medicine, Milano, Italy; Division of Senology, Milano, Italy; Division of Epidemiology, Milano, Italy; Department of Medicine, Milano, Italy; Division of Pathology, Milano, Italy; Division of Radiotherapy, Milano, Italy; Division of Senology, Milan, ItalyAbstract: We evaluated 2999 consecutive postmenopausal women aged > 50 years with first diagnosis of invasive breast cancer referred to surgery at the European Institute of Oncology from April 1997 to February 2002. Biological characteristics for estimation of risk and therapy responsiveness were evaluated as follows: Estrogen and progesterone receptors (ER and PgR), vascular invasion (VI), grade, Ki-67, HER2 overexpression and pathological stage according to TNM. Numbers of patients anddistribution of main prognostic and predictive findings are displayed in table. VI decreased with age from 30.6% in young postmenopausal to 24.6% in elderly. Neither grading nor Ki67 were associated with aging. Incidence of comorbidities was greater among elderly patients: 28% reported no comorbidities compared with 55% of the other groups. Surgical approaches were similar in the three groups while radiotherapy was not prescribed to 65.3% of the elderly who had breast conservation compared with 37.2 and 43.2 of younger and older cohorts, respectively. Chemotherapy was proposed to 6.4% of elderly group compared to 35.4% of other 2 groups. Within ER positive patients endocrine treatment has been proposed to 89.74 % of elderly respect to 76.9% of young postmenopausal and 84.34% of older patients. Decision making has been oriented to propose no systemic therapy (either chemo- or endocrine therapy) in 23.07% of elderly compared to 9.3 and 6.7 % of young and older patients. In summary, elderly patients referred to surgery are likely to have a higher metastatic potential of the disease (more N+) and more of them are likely to have an endocrine responsive disease. Reluctance to prescribe treatments is due to complexity of cost-benefit evaluation in such patients, who obviously have, on average, a shorter life expectancy. Trials of tailored therapies should be activated to improve treatment outcome in these patients. Prognostic findings
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