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Pattern of care and survival in older women with breast cancer in India

Published online by Cambridge University Press:  23 November 2010

Budhi S. Yadav ,
Suresh C. Sharma ,
G. Menu ,
A. Mohmad ,
Firuza D. Patel ,
K. Nisar  and
G. Sushmita
Budhi S. Yadav
Affiliation:
Pinnacle Cancer Care Centre, Ivy Hospital, Sector-71, Mohali, India
Suresh C. Sharma
Affiliation:
Department of Radiation Oncology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
G. Menu
Affiliation:
Department of Radiation Oncology, Sher-i-Kashmir Institute of Medical Sciences, Kashmir, India
A. Mohmad
Affiliation:
Department of Radiation Oncology, Sher-i-Kashmir Institute of Medical Sciences, Kashmir, India
Firuza D. Patel
Affiliation:
Department of Radiation Oncology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
K. Nisar
Affiliation:
Department of Radiation Oncology, Sher-i-Kashmir Institute of Medical Sciences, Kashmir, India
G. Sushmita
Affiliation:
Department of Radiation Oncology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Abstract

Purpose: To determine the pattern of care and survival in older patients with breast cancer.

Methods: The study population included 228 women aged ≥60 years with breast cancer treated between 1992 and 2002. Analysis was done for surgery, radiotherapy (RT), chemotherapy and hormonal therapy. Outcomes studied were locoregional recurrence (LRR) distant metastases, disease-free survival (DFS) and overall survival (OS) using univariate and multivariate analyses. Kaplan–Meier method was used to estimate DFS and OS.

Results: Mastectomy was done in 208 (91%) patients and conservative breast surgery (CBS) only in 20 (9%) patients. Majority of the patients received adjuvant RT 179 (78.5%). Chemotherapy was given to 49 (21.5%) patients and hormones to 204 (89.5%) patients. LRR with or without distant metastases was 7% and distant metastasis rate was 19.3%. DFS at 10 years was 69%. With RT, DFS was 76% in patients aged <65 years and 73% in aged ≥65 years (p = 0.13). It was 73 and 86%, respectively, with chemotherapy (p = 0.041). DFS with hormones was 96% in patients aged ≥65 years and 79% in aged <65 years (p = 0.028). The OS was 74% at 10 years. RT improved OS in all patients. OS with chemotherapy was 94% in patients ≥65 years, and 82% in patients <65 years (p = 0.044). With hormonal therapy OS was 96% in patients aged ≥65 years and 78% in patients <65 years (p = 0.020).

Conclusion: CBS rate and chemotherapy use is very low in elderly women with breast cancer in India. Adjuvant RT, chemotherapy and hormonal therapy offered a therapeutic advantage in these patients.

Keywords

Breast cancerChemotherapyHormonesRadiotherapy
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 9 , Issue 4 , December 2010 , pp. 237 - 245
Copyright
Copyright © Cambridge University Press 2010

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