Breast-conserving therapy in older patients with breast cancer over three decades: progress or stagnation

Background: The aim of this study was to analyze the distant metastases-free survival (DMFS), and disease-specific survival (DSS) after breast-conserving therapy (BCT) in older patients with breast cancer in a large, population-based, single-center cohort study with long-term follow-up. Material and Methods: Analyses were based on 1,425 women aged 65 years and older with breast cancer treated with BCT. Patients were divided in three age categories: 65 – 70 years, 71 – 75 years, and >75 years. The study period extended over 30 years, divided in three decades. Multivariate survival analysis was carried out using Cox regression analysis. Results: The two youngest age categories showed significant improvements over time in 12-year DMFS and DSS. For women aged 65 – 70 years, this improvement was noted in stage I and stage II disease, while for women aged 71 – 75 years this was mainly in stage II tumors. Women >75 years of age did not show any improvement over time, regardless of stage. Conclusion: Among older Dutch women with breast cancer, outcomes with regard to DMFS and DSS after BCT differ between various age categories, showing the least gain in the very old.

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