Breast cancer care for the aging population: a focus on age-related disparities in breast cancer treatment
Serena Bertozzi, Ambrogio P. Londero, Josè Andres Diaz Nanez, Roberta Di Vora, Barbara Baita, Lucia La Verghetta, Serena Prada, Luca Seriau, Laura Mariuzzi, Carla Cedolini
Abstract
Breast cancer is a significant health issue for women worldwide and poses unique challenges for all ages. Older women face many concerns about breast cancer treatment and outcomes. This study aims to compare breast cancer management and outcomes across various age groups within a single-center experience in a region with an aging population, focusing specifically on women aged 70 and older to identify potential disparities in treatment and prognosis. We conducted a retrospective analysis of all female patients diagnosed with breast cancer at our local reference Breast Unit in northeastern Italy between January 2002 and July 2023. The primary outcome measures in this study were overall survival (OS), disease-free survival (DFS), cumulative loco-regional recurrences, and cumulative distant recurrences. The study included 2478 women over 70 (31.12%), 4690 women aged between 45 and 69 (58.90%), and 795 women under 45 (9.98%). According to the study, older women were more likely to have advanced-stage cancer, whereas they received less aggressive treatment, including fewer adjuvant therapies and surgical interventions. We also observed worse prognoses in this group of patients if compared with women aged 45 to 69 years. Moreover, data showed that the incidence of breast cancer among older women has increased over time. Our findings highlight the need for tailored treatment strategies for older breast cancer patients to balance treatment efficacy with quality-of-life considerations. These findings call for a strategic reevaluation of treatment protocols and emphasize the importance of personalized care, particularly for older women, to improve outcomes without sacrificing the quality of life while maintaining maximum survival potential. ∙ Our analysis identifies significant treatment disparities between women over 70 and younger age groups in breast cancer management. ∙ Our study documents the rising incidence of breast cancer in women aged 70 and older, emphasizing the urgency of addressing this demographic issue. ∙ Our study emphasizes the need for tailored treatment strategies that balance cancer control with quality of life for the elderly. ∙ Our results advocate including older women in clinical trials to ensure that findings are representative and applicable to this growing patient population.