How long are Elderly Patients Followed up with Mammography after the Diagnosis of Breast Cancer? A Single-Centre Experience in a Developing Country

ABSTRACT

BACKGROUND:The effect of breast cancer on elderly South African (SA) patients is not well characterised. The lack of data with regard to disease burden; post-treatment surveillance and breast cancer relapse poses a challenge to providing optimum follow-up care to this group of patients. OBJECTIVES:To assess the effect of breast cancer and adherence to post-treatment surveillance programmes among the local elderly population attending the breast oncology clinics at Addington and Inkosi Albert Luthuli Central hospitals in Durban; KwaZulu-Natal; SA.METHODS: A retrospective review was undertaken of all patients aged =65 years diagnosed with breast cancer during 2007. Hospital records were reviewed for a period of 5 years to ascertain the stage of the disease; treatment received; adherence to post-treatment surveillance mammograms; incidence of new mammographic findings and recurrence; site of recurrence; mode of detection of recurrence; disease-free survival; and overall survival rates at 5 years.RESULTS:In our study; the incidence of breast cancer in the elderly population was 26.7%. A significant percentage of patients (56.3%) were diagnosed at an advanced stage of disease. Of the 46.9% who had received surveillance mammography; only 6.3% received their post-treatment surveillance mammograms on time; in accordance with international recommendations. New mammographic findings were detected in 26.7% of patients during the 5-year follow-up. During the follow-up period; 15.6% of the total number of study patients presented with disease recurrence. Eighty percent of cases of recurrence were detected clinically. The overall survival at 5 years was 65.6%. CONCLUSION:Our study highlights the significant number of elderly patients with advanced disease at diagnosis; poor compliance with internationally recommended annual post-treatment surveillance mammograms; and the relatively low overall 5-year survival rate compared with that of international studies