Breast cancer incidence increases with age, and elderly patients are frequently underrepresented in clinical trials. This study aimed to show the tumor and treatment characteristics, toxicity and survival differences in the groups under and over 65 years who received adjuvant radiotherapy.
METHODS
Between 2010-2023, 1265 patients who underwent adjuvant radiotherapy were retrospectively evaluated. Patients were categorized into <65 years and ≥65 years. Demographic characteristics, treatment modalities and treatment outcomes were compared between the groups.
RESULTS
Of all patients, 14.7% were aged 65 years and older. Median overall survival (OS) was 158.4 months in patients younger than 65 years and 122.7 months in those aged 65 years and older (p<0.001). Age ≥65 years was identified as an independent prognostic factor for both OS and disease-free survival (DFS). Elderly patients received chemotherapy less frequently and were more often treated with hypofractionated radiotherapy. Mortality rates were significantly higher in the ≥65 age group.
CONCLUSION
Patients aged 65 years and older had worse DFS and OS compared with younger patients. Elderly patients were less likely to receive chemotherapy and more likely to receive hypofractionated radiotherapy. Treatment decisions should be individualized, and chronological age alone should not be the sole determinant in therapeutic planning.