Breast cancer in elderly women features in Tunisian women

 

 

Objective: The aim of this study was to describe patient socio-demographic characteristics and clinical features of breast cancer in women aged 65 years old or more.

Design: this was a retrospective and descriptive study.

Methods: We reviewed files of 60 women aged 65 years at least and treated for breast cancer the gynaecology and obstetrics department of Ben Arous Regional Hospital between January 2015 and December 2022.Data on patient characteristics, cancer presentation were collected and analyzed.

Results:

The mean age of our population was 70±5 years. Among them, 10.1% were older than 80 years old. Thirteen percent of these patients had a medical history of breast cancer in their family and just one patient had a medical history of endometrial cancer. In all, 12% of patients in the old population did not have comorbidities. Cardiovascular diseases, predefined as hypertension, thromboembolic, valvulopathy, pulmonary embolism, previous myocardial infarction, and previous ictus, were present in 42 women (70%). The age at first menarche was 12 years old in 40% of cases. Thirteen percent of the patient were nulliparous and 85% had breastfed their babies. Pregnancy was noticed in 88.3% of cases and 16.7% used oral contraceptive method. 32 patients out of 60 (53.3%) discovered a lump in the breast by self-examination. Conversely, diagnosis through periodic screening occurred in 17% of cases. Occasional diagnosis, predefined as diagnosis done during medical procedures for different reasons, occurred in 29.7% of cases.

Sixty percent of patients were diagnosed with stage 2 disease and 33.4% with stage 4. Pathological subtype was invasive ductal carcinoma in 71% of cases and 13% were lobular. Treatment strategy was mainly based on a radical surgery with radiotherapy and chemotherapy. During the follow up period, metastatic disease occurred in 18.3% of cases. Twelve patients died due to disease progression. Overall survival after treatment was about 53.3%.

Conclusion: Optimal approach to elderly women with breast cancer is still a major challenge. Elderly patients with cancer should have at least a brief geriatric assessment to detect potentially treatable problems not always adequately evaluated by the oncologists.