Clinico-Pathological Features of Breast Cancer and Impact on Survival in Elderly Patients / By Majed Ahmed El-sayed Hussien ; Supervised by Prof. Dr. Hanan Ramadan Nassar Mohame, Prof. Dr. Amany Mohamed Helal, Prof. Dr. Amrallah Abd El-Moneem Mohamed Sayed

Thesis (M.Sc.)-Cairo University, 2023.

Bibliography: pages 91-108.

the objective of this study is to analyze clinic pathological features
of breast cancer in elderly women and impact on survival.
Patients and methods: retrospective analysis (SPSS) was conducted based on
medical records of patients who were treated in National Cancer Institute, Cairo
University and Meet-Ghamr Oncology Center in the period between January 2012
and December 2016.
Results: The study included 343 breast cancer patients with mean age 68.8±4.3
years. About 82.8% of the included patients had negative history of taking OCPs.
About 57.4% had other medical conditions than breast cancer. Hypertension
(46.4%) and diabetes (30%) had the highest prevalence followed by cardiac
diseases (11.4%). Other medical disorders as renal (0.9%), hepatic (2.9%) and
respiratory diseases (2.0%) were reported with lower frequencies. Associated
medical disorders did not affect the overall 3 and 5 years survival rate. The
pathological type of 258 out of 343 breast cancers was invasive duct carcinoma.
Invasive lobular carcinoma type had the 2nd common pathological types (7.9%).
Other breast cancer pathological types had variable lesser frequencies. Regarding
pathological grading, grade II had the highest frequency among all lesions (77%).
About 61.8% of patients were T2 and 14.9% were T1 or T3. A percent of 41.1%
were N0 while 24.5% were N1. Most of patients were M0 (94.2%). Estrogen
receptors and Progesterone receptors positive lesion had the highest frequency
(79.6%; 74.9% respectively). While, Herceptin receptors positive lesions
frequency was low ( 1 5 . 5 % ) . A number of 339 patients (98.8%) underwent
surgical removal of breast mass while 4 patients only did not undergo surgeries.
Modified radical mastectomy (MRM) was the main surgery followed by BCS.
Simple mastectomy was performed in 13 patients and toilet mastectomy was
performed in 2 patients. Pathological type and grade did not affect the 3 and 5
years patient survival. Expression of ER and PR was associated significantly with
better survival. The 3 years disease free survival rate was 85.9% and 5 years
disease free survival rate was 81.6% after exclusion of the 20 patients that had
Mets at diagnosis for more accurate results as they were not supposed to become
disease free at any time point during the study.
Conclusion: breast cancer in elderly patients is aggressive from the time of
diagnosis and so further studies are needed to evaluate better managemen

لقد تزايد معدل الاصابه بسرطان الثدى في كبار السن مع ارتفاع وسائل التشخيص والمسح، حيث يمثل التقدم في السن عامل خطوره على معدل النجاه ما لم يكن عائقا في تلقي العلاج كما هو الحال مع المرضى الاقل عمرا مع الاخذ بالاعتبار الحاله العامه والامراض المصاحبه لدى المرضى. ومن نتائج الرساله تبين ارتفاع نسبة تعافي المرضى بعد خضوعهم لعملية الاستئصال الجذري اكثر من التحفظي لاورام الثدي حيث تمثلت النسبه الاكبر لدى المرضى ذوي المراحل الاولى من الورم.
يعد اختيار العلاج المناسب للمرضى كبار السن المصابين بسرطان الثدي تحديا فيما يتعلق بالحاله العامه للمرضى, الامراض المصاحبه والحاله النفسيه وتقبلهم للعلاج خاصة لمرضى القلب والكلى. كما يختلف قرار العلاج بناءا على مرحلة الورم ما بين علاج جراحي, كيماوي, اشعاعي, هرموني وعلاج موجه بعد دراسة بيولوجيا الورم.

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Text in English and abstract in Arabic & English.