The effect of treatment preferences on survival in early stage breast cancer in elderly patients over 65 years of age

Background The increasing incidence and mortality of breast cancer with age remains a major health concern, particularly in the elderly population. However, the under-representation of older patients in clinical trials complicates our understanding of the characteristics of this population. In this retrospective study, we evaluated breast cancer patients aged 65 years and older with early-stage hormone receptor-positive, HER2-negative disease. Method A total of 157 patients were included in the study. We compared groups who received postoperative chemotherapy or hormonal therapy, and evaluated several clinical and pathological factors.Factors affecting relapse-free survival (RFS) and overall survival (OS) were evaluated. Results Our results showed a lower overall survival in the hormone therapy group compared to the chemotherapy group. However, this difference suggested the influence of not only the preference for non-aggressive treatments, but also the effect of comorbidities and life expectancy. Analysis of the causes of death showed that coronary heart disease was prominent in the hormone therapy group, suggesting that most deaths were due to causes other than breast cancer recurrence. Conclusions Our results highlight the importance of considering overall health and life expectancy when deciding on treatment options for advanced breast cancer patients. In addition, findings suggesting that aggressive treatments in older patients may provide limited benefit and reduce quality of life emphasise the need for more personalised treatment strategies in this population.