Surgery may improve overall survival (OS) in patients with invasive breast cancer who are 80 years of age or older, according to research published in Clinical Breast Cancer.

The study authors noted that there are no established treatment guidelines for breast cancer patients who are 80 years of age or older, and there is “limited evidence on treatment patterns and survival outcomes” in this group.

The researchers evaluated data from the National Cancer Database to determine whether particular treatment strategies improve survival in patients with invasive breast cancer who are 80 years of age or older.

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Data from 62,575 patients were included in the study. Most patients (81.2%) were non-Hispanic White, 57.9% were ages 80 to 84 years, 51.4% had stage I disease, and 82.9% had estrogen receptor-positive disease.

The vast majority of patients (94.4%) underwent surgery, 52.8% received endocrine therapy, 34.5% underwent radiation, and 5.8% received chemotherapy. White patients, patients younger than 90 years of age, and those with lower disease stage or fewer comorbidities were more likely to undergo surgery.

For the entire cohort, the median follow-up was 3.9 years, and the median OS was 6.4 years.

The median OS was significantly longer in patients who underwent surgery than in those who did not — 6.7 years and 2.4 years, respectively (hazard ratio, 3.3; P <.001).

Surgery was an independent predictor of OS in a multivariate analysis (P <.001).

A subtype analysis showed that both surgery and radiation were associated with improved OS for all subtypes (luminal A, luminal B, HER2-positive, and triple-negative breast cancer). Chemotherapy was also associated with improved OS for patients with triple-negative breast cancer.

“The choice to include surgery as part of breast cancer management in older women should not be based on age alone but should include a careful assessment of surgical risks and benefits, an individual fitness assessment, and discussion of therapy goals with patients, their families, and the multidisciplinary breast cancer team,” the study authors wrote.


Frebault J, Bergom C, Cortina CS, et al. Breast cancer treatment patterns in women age 80 and over: a report from the National Cancer Database. Clin Breast Cancer. Published online July 15, 2021. doi:10.1016/j.clbc.2021.07.005