CLINICOPATHOLOGICAL PROFILE AND OUTCOME OF ELDERLY EARLY-STAGE BREAST CANCER PATIENTS AGE 75 YEARS OR OLDER: SERIE FROM NATIONAL CANCER INSTITUTE – BRAZIL

Background: Breast cancer patients above 75 years old represent an heterogenous population, often not included in clinical trials. Although treatment decision should not be guided by age but fitness, elderly patients were historically treated distinctly than younger patients. Objective: This study aimed to determine the clinicopathological profile and survival outcomes of early-stage breast cancer patients 75 years or older. Methods: From January 1st, 2012 to December 31st, 2015, demographics, baseline clinical characteristics, pathology, and treatment details were retrospectively extracted from medical records to an electronic database. Qualitative variables were described by absolute and relative frequencies. Results: A total of 252 BC eligible patients were included. The median age was 80.2 years, most patients (78,7%) had ECOG performance status 0 or 1, 65,1% were white. At diagnosis, 28.8% of patients had clinical stage (CS) I, 43.1 % had CS II, 28% had CS III. Histologically, 76.6% had IDC, 6.3% had ILC, 1.2% in situ lobular/ductal and 16.3% others. Intermediate and high-grade tumours represented 67.5% and 15.1%, respectively. The majority were hormone receptor positive (89.6%) and HER2 was overexpressed in 6.7%, but in 21.8% the HER2 status was unknown. Patients underwent mastectomy in 45.8% of cases, 20.3% were offered neo/adjuvant chemotherapy and 73.8% received hormone therapy. At a median follow-up of 60 months, locoregional recurrence occurred in 5.2% of cases, 6.7% of patients developed distant metastases and 24.2% died. Conclusion: Patients 75 years or older had more advanced disease at diagnosis without having a poor performance status. Majority had primary breast surgery. Adjuvant hormone therapy was the treatment of choice due to good tolerance in this group. Strategies to improve BC screening and appropriate treatment among these patients should be considered due to the progressive increasing in life expectancy and differences found between chronological and biological age.