Sバンドレーダによって観測された台風によるクラッタの抑圧(電気電子工学科 柳繁教授に捧ぐ)

Objective: To identify the incidence and imaging pattern of breast cancer in the elderly (over 65) with the aim of identifying guidance relating to breast screening in this age group. Material and Methods: From our departmental data system, the number of patients who had mammograms between 2009 and 2011 were calculated and the number over 65 were identified. The total number of cancer patients during that period and those over 65 were identified. An analysis of the imaging findings with standard mammographic, ultrasound, MR, CT and bone scans were made. Pathological findings were also reviewed. Results: Out of 18,482 patients who had mammography, 724 were over 65 making a percentage of 3.9. Out of a total of 523 cancer cases, 59 (11.3%) were over 65 years of age. A pie chart revealed a greater contribution of cancer by this age group. The breast pattern was often involuted making cancer detection easy. Over half the patients with breast cancer who were symptomatic had advanced cancers which were grade 3. Lower grade cancers occurred in various non ductal type of cancers and in the screening population where slow growing tumors were found. Conclusion: Advanced breast cancer with histologic high grade occurred frequently in the symptomatic elderly women while screen detected cancers were small, easily identified and tend to be low grade. Therefore, the findings support breast screening in the elderly population in order to retain a good quality of life. Increasing age is a well-known risk factor in breast cancer development. An annual cancer incidence from the US reports that almost one-half of breast cancer in women occurs in women 65 years of age and older [1,2]. On the contrary, a younger age group involvement is reported in the Gulf, where 50% occur in females below 50 years of age [3]. Clinical observation had defined breast cancer as a more indolent disease in the elderly and this has been confirmed by the pattern of tumor biology, which includes higher expression of steroid hormone receptors, lower proliferative indices, absence of expression of epidermal growth factor receptor (EGFR) and HER2 [4-7] in older women. There are also reports, which indicate that the older women have worse outcome [8] and this has been attributed to both under treatment and an advance disease stage than younger women [5,8-10]. There is also information, which states that increased age was a significant determinant of decreased survival, even among women of stage I or II disease [9]. Although screening would permit early diagnosis in this age group, the impact on mortality is controversial. Therefore, breast screening in this age group is under reported and controversial. Indeed, randomised control data about the effectiveness of mammography screening in older women are absent. Within the same country like the United States, various guide line [11-13] about screening in older women exists. Although, there is currently no national screening program in most of the Gulf States, breast screening does occur in some section of the population. Amidst the controversy of screening in the elderly and limited information about the pattern of breast cancer in our elderly population, this study therefore aims at identifying a. ) The percentage of breast cancer detected in our practice in the over 65 years. b. ) The imaging pattern. c. ) Some guidance for screening in the elderly. Materials and Method The Data System from the breast imaging and intervention system of our department was used. The number of breast cancer patients diagnosed between 2007 to 2011 were recorded. The number of patients, who were over 65 years, was identified. The number of patients, who had mammograms between September 2007 and 2011 were calculated and the number of over 65 years were identified. An analysis of the imaging findings with standard mammographic, ultrasound MR, CT and Bone Scans were reviewed. All breast cancer cases are usually discussed in our regular multidisciplinary meetings. Patients who had breast cancer diagnosed and treated elsewhere before coming to us were excluded. Special ethical consent of this study is not needed due to the retrospective nature of the study.