Impact of older age on presentation, management and outcome of breast cancer in the multi-ethnic Asian population of Singapore Nakul Saxena a , Mikael Hartman a, b, ⁎ , Zakir Hussain a , Nirmala Bhoo Pathy c , d , Philip Iau b , Soo Chin Lee e , Khai Mun Lee f , Siew Eng Lim e , John E.L. Wong e , Helena M. Verkooijen a, c a Department of Epidemiology and Public Health, National University of Singapore, Block MD3, 16 Medical Drive, Singapore 117597, Singapore b Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, c/o National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074, Singapore c Division of Radiology, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands d Julius Centre University of Malaya, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia e Department of Hematology Oncology, National University Cancer Institute, National University of Singapore 119074, Singapore f Department of Radiation Oncology, National University Cancer Institute, National University of Singapore 119074, Singapore ARTICLE INFO ABSTRACT Article history: Received 22 June 2010 Received in revised form 23 July 2010 Accepted 10 August 2010 Available online 6 September 2010 Aim: This study aims to improve insight in breast cancer characteristics and outcome in the understudied population of elderly Asian women with breast cancer. Patients and methods: We identified 2195 women, ≥ 40 years, diagnosed with breast cancer between 1990–2007 at the National University Hospital in Singapore. Patient and tumor characteristics, treatment and outcome were compared between women diagnosed at age < 65 years and ≥ 65 years. Results: Older women were more often diagnosed with advanced stages and estrogen receptor positive tumors. They were less likely to have undergone axillary clearance, radiotherapy post breast conserving surgery and chemotherapy for lymph node positive disease. Older women had poorer relative survival than younger women; however these differences largely disappeared after stage stratification. Conclusion: Similar to Western populations, older Asian breast cancer patients present with more advanced stages and are less likely to receive standard treatment. Older age was not associated with worse survival within different stage strata. © 2010 Elsevier Ltd. All rights reserved. Keywords: Breast cancer Elderly patients Relative survival Treatment Diagnosis 1. Introduction Breast cancer is the most common type of cancer and the most common cause of cancer death among women worldwide. 1 Breast cancer is a disease of the elderly 2,3 with a majority of Caucasian patients being over 65 years of age at diagnosis. 4,5 In contrast to Europe and the US, where breast cancer incidence rates have stabilized or even decreased, Asian breast cancer rates are increasing dramatically. 6–8 With the Westernization of Asian countries, one can expect this trend JOURNAL OF GERIATRIC ONCOLOGY 2 (2011) 50 – 57 ⁎ Corresponding author. Department of Epidemiology and Public Health, National University of Singapore, Block MD3, 16 Medical Drive, Singapore 117597, Singapore. Fax: + 65 67791489. E-mail address: ephbamh@nus.edu.sg (M. Hartman). 1879-4068/$ – see front matter © 2010 Elsevier Ltd. All rights reserved. doi:10.1016/j.jgo.2010.08.002 available at www.sciencedirect.com