At what rate does advanced age affect decision making on neoadjuvant therapy?

Abstract

Introduction: Increasing numbers of patients with breast cancer receive neoadjuvant therapies. We investigated differences in survival rates between geriatric and non-geriatric patient groups following administration of neoadjuvant therapies. Materials and Method: We examined 166 patients who received neoadjuvant therapy for breast cancer between 2007 and 2016. Patients <70 years were in Group 1 and those ≥70 years were in Group 2. We retrospectively compared age, sex, treatment, tumour stage and localisation, status of oestrogen and progesterone receptors, involvement of axillary lymph nodes, systemic treatment complications, treatment compliance and survival rates using a variety of parametric and non-parametric statistical tests. Results: The mean ages of patients in Group 1 [n = 136] and Group 2 [n = 30] were 44.6 ± 8.92 and 76.7 ± 5.48 years, respectively. The most common tumour location was the upper-outer quadrant. All patients received treatment consisting of 4AC [doxorubicin-cyclophosphamide] + 4 taxane or 4AC [doxorubicin-cyclophosphamide] + paclitaxel for 12 weeks. Neither group exhibited mortality or complications requiring treatment interruption. Breast-conserving surgery was performed in 88 [53%] patients. Complete response was achieved in 14 [8%] patients after surgery. Mean tumour diameters in Groups 1 and 2 were 26.8 mm [±27.59] and 28.5 mm [±40.23], respectively. Five-year general survival rates were % 69,7 in Group 1 and % 70 in Group 2[ p = 0.94]. Conclusion: Neoadjuvant therapy is a reliable treatment option in patients ≥70 years who are candidates for chemotherapy, since complication and mortality rates did not increase compared with younger patients.