Prof Wildiers and his colleagues investigated 2,227 women who had been treated for breast cancer between 2000 and 2006 at the University Hospitals Leuven. Then they compared the results with a separate database of over 11,000 breast cancer patients on the Eindhoven Cancer Registry.
They found that for women aged 70 or younger, increasing age was associated with a decreased prevalence of cancer spreading to the lymph nodes. The womens risk of having positive lymph nodes decreased by 13% for every decade they aged, up to age 70.
Once aged 70 and over, the odds of lymph node involvement doubled with every 10-year increase in age for women who had tumours that were no bigger than 15mm across. If the tumours were larger than 42-43 mm, then risk of lymph node involvement continued to decrease.
Prof Wildiers said: We know that the elderly have depressed immune defences, and, therefore, it is possible that these decreased defences are unable to prevent invasion of the lymph nodes by metastases in a subset of breast tumours in elderly women. Although breast cancer survival in older women appears to be similar to survival in the general population irrespective of disease status, it might well be that there is a balance in the elderly between, on the one hand, a less aggressive type of tumour, and, on the other hand, their decreased immunological defences.
He said the findings supported the idea that there are two types of tumour in elderly women: ones that are slow-growing and dont invade the lymph nodes even if the tumours are larger, and ones that are aggressive and metastasise very early to the lymph nodes. Women with slow-growing tumours might benefit from less aggressive treatment, while the smaller tumours in the women aged over
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ECCO-the European CanCer Organisation