Analysis of differences in clinicopathological characteristics and prognostic factors between elderly and non-elderly female breast cancer patients
Objective Comparison with non-elderly patients to analyze the clinicopathological characteristics of elderly female breast cancer(BC)patients and to explore the factors influencing their prognosis.Methods Data were collected from 86,064 female BC patients in the National Cancer Institute's Surveillance,Epidemiology,and End Results(SEER)database,spanning from 1975 to 2015.Patients aged 65 and older were classified as the elderly group,while those under 65 were designated as the non-elderly group.The baseline characteristics and clinicopathological differences between the two groups were analyzed using the chi-square test.The Kaplan-Meier method was employed to plot overall survival(OS)and breast cancer-specific survival(BCSS)curves for both groups.Additionally,factors influencing OS and BCSS in elderly BC patients were examined through univariate and multivariate Cox regression analyses.Results In comparison to the non-elderly group,elderly BC patients exhibited a higher proportion of white individuals,widows,residents from non-metropolitan areas,lower median household income,lower histological grade,and earlier clinical stage.Furthermore,this group demonstrated a greater prevalence of estrogen receptor(ER)and progesterone receptor(PR)positivity,a lower prevalence of human epidermal growth factor receptor 2(HER2)positivity,and fewer individuals received standard treatment(all P<0.001).The prognosis for the elderly group was poorer,characterized by increased risks of all-cause mortality and breast cancer-specific mortality(P<0.001).Multivariate analysis revealed that receiving standard treatment served as a protective factor for both OS and BCSS in elderly patients.Conclusions In this cohort,elderly breast cancer patients were characterized by an earlier clinical stage,lower histological grade,higher rates of ER and PR positivity,and a lower rate of HER2 positivity.Their OS and BCSS rates were significantly worse than those of the non-elderly group.The analysis indicates that inadequate and non-standard treatment is a major influencing factor,necessitating increased attention from clinicians.