Breast cancer treatment in the elderly: Do treatment plans that do not conform to NCCN recommendations lead to worse outcomes?

Aging remains one of the greatest risk factors for development of new breast cancer with more than 30% of breast cancers occurring after the age of 75. Elderly women have been found to not conform with all aspects of treatment recommendations. Our study compared outcomes of elderly breast cancer patients whose treatment did or did not conform to NCCN guidelines. A retrospective review was conducted of breast cancer patients over the age of 70. Comparisons were made between patients whose treatment did or did not conform to NCCN guidelines for recurrence, metastatic disease, and breast cancer related deaths. Patients whose treatment did not conform to NCCN guidelines were older (80.5 vs. 77.7 years, P = 0.001). No significant difference was seen between groups for tumor size, breast cancer type, or nodal status; however, more nonconforming women were ER/PR positive (90.3% vs. 76.6%, P = 0.020). There was no significant difference in local recurrence, metastatic disease, or breast cancer related deaths. Women whose treatment did not conform to NCCN guidelines were not associated with worse outcomes. •Breast cancer outcomes were compared in conforming and nonconforming elderly patients.•Nonconforming women were older than conforming women (80.5 vs. 77.7 years, P = 0.001).•Local recurrence and metastatic disease rates were similar between study groups.•Breast cancer related mortality was also similar between study groups.•Treatment nonconformity was not associated with poorer outcomes in elderly patients.