SAGE-Hindawi Access to Research International Journal of Breast Cancer Volume 2011, Article ID 467906, 7 pages doi:10.4061/2011/467906 Clinical Study Breast Cancer Treatment Practices in Elderly Women in a Community Hospital Hua Wang, Awinder P. Singh, Serena A. St. Luce, and Alan R. Go Department of Surgery, The Brooklyn Hospital Center, 121 Dekalb Avenue, Brooklyn, NY 11201, USA Correspondence should be addressed to Alan R. Go, arg9003@nyp.org Received 10 May 2011; Accepted 20 September 2011 Academic Editor: Owen A. Ung Copyright © 2011 Hua Wang et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Elderly women with breast cancer are considered underdiagnosed and undertreated, and this adversely aﬀects their overall survival. Methods. A total of 393 female breast cancer patients aged 70 years and older, diagnosed within the years 1989– 1999, were identiﬁed from the tumor registry of The Brooklyn Hospital Center. Comparisons between the 3 diﬀerent subgroups 70–74, 75–79, and 80 years and older were made using the Pearson Chi Square test. Results. Lumpectomy was performed in 42% of all patients, while mastectomy was done in 46% of patients. Adjuvant therapy such as chemotherapy, radiation therapy, and hormonal therapy were done in 12%, 25%, and 38%, respectively. Forty-seven percent of patients with positive lymph nodes received chemotherapy. Eighty-six percent of patients who were estrogen receptor-positive received adjuvant hormonal therapy. Overall ﬁve-year survival was only 14% for the ≥80 age group, compared to that of 32% and 35% for the 70–74 and the 75–79 age groups, respectively. Conclusions. Surgery was performed in majority of these patients, about half received lumpectomy, the other half mastectomy. Adjuvant therapies were frequently excluded, with only hormonal therapy being the most commonly used. Overall ﬁve-year survival is signiﬁcantly worse in patients ≥80 years with breast cancer. 1. Introduction Breast cancer is still the most common cause of death for women in the United States. Interestingly, we see that as the population ages, we likewise see an increase in the number of patients diagnosed with breast cancer. Increasing age remains the greatest risk factor in developing the disease. It is estimated that by 2030, 20% of Americans will be over the age of 65. Studies have shown that around 50% of patients with breast cancer are those older than 65 years of age and that approximately 35% are older than 70 years [1, 2]. Most women who die of breast cancer are over the age of 65 [3, 4]. Yet despite this information, it is observed in a number of studies that elderly patients do not receive the standard treatment when compared to their younger counterparts [5, 6]. And at the heart of this dilemma is that as patients advance in age, the incidence of cancer increases, but so does signiﬁcant medical comorbidities. And it is the latter that may signiﬁcantly aﬀect treatment options in most patients. However, a number of studies have cited that age alone was a determining factor in the type of treatment a patient with breast cancer would receive [7, 8]. Studies collectively show that older patients with breast cancer are more likely to be undertreated compared to younger patients [9, 10]. To date, there is no consensus as to what the best treatment is for older patients [9]. Part of it is because older breast cancer patients are not very well represented in clinical trials [11]. There are also suggestions that treatment should include consideration of nonbreast- cancer-speciﬁc survival, functional status, and patient and family preference (goals of care). In terms of life expectancy, data from the National Vital Statistics Reports from the Centers for Disease Control and Prevention (CDC) released in 2003 have shown that females at age 70 have an average life expectancy of 15 years if they are relatively healthy and 7 years for those over 85 years old [12]. The care for an elderly breast cancer patient is indeed very complicated. Thus, treatment of an elderly patient should be multidisciplinary, possibly requiring the expertise of a primary care physician, a geriatrician, a psychiatrist, a surgeon, and a medical and radiation oncologist. Screening is likewise very controversial in the elderly population. There are very few retrospective and prospective