269P - Achieving treatment goals in elderly breast cancer patients with neoadjuvant chemotherapy: A remarkable insight

Background

Neoadjuvant chemotherapy (NAC) is widely used for locally advanced breast cancer, including HER2-positive and triple-negative subtypes. However, the impact of age on treatment response remains uncertain. This study aims to investigate treatment outcomes in elderly breast cancer patients receiving neoadjuvant chemotherapy.

Methods

A retrospective analysis was conducted on breast cancer patients who underwent neoadjuvant treatment at two tertiary centers between 2010 and 2021. Patients were divided into two groups based on age: ≥65 years and <65 years. Pathologic response and surgical outcomes were compared between the groups.

Results

A total of 535 patients were included in the study, with 12% aged ≥65 years. There were no statistically significant differences in the clinicopathological characteristics between older and younger patients. The overall rate of receiving anthracycline-based chemotherapy (CT) in the entire population was 97.6%, with ddAC used more in the younger patients (71.7% vs 38.5%, p<0.001). Breast-conserving surgery and sentinel lymph node dissection were comparable between the groups. In older patients, the rate of breast downstaging was 73.5% and the rate of axillary downstaging was 70.6%, with no statistically significant difference compared to younger patients. A comparison of the groups in terms of pathological complete response revealed rates of 26.6% in younger patients and 33.3% in older patients (p>0.05). The rate of grade 3-4 toxicity was statistically higher in elderly patients (71% vs. 46.4%, p<0.01). No treatment-related deaths were observed. The median follow-up period was 50 months. Recurrence occurred in only 84 (17%) patients, with a recurrence rate of 10.4% in elderly patients compared to 17% in the other group (p=0.17).

Conclusions

The study suggests that elderly patients achieve similar outcomes to younger patients, indicating that age alone should not be a basis for undertreatment. Further research focusing on personalized approaches for the geriatric population is needed.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.