Beyond The Age Limit: A Comparative Study (<70 Vs ≥70 Years) in Breast Cancer Characteristics and Surgical Management in Women

Suleyman Buyukasik,1 Burak Kankaya,1 Yusuf Emre Altundal,1 Mustafa Ozgul,2 Selin Kapan1 1Department of General Surgery, Faculty of Medicine, Istanbul Aydin University, Istanbul, Turkey; 2Department of Ophthalmology, Gavin Herbert Eye Institute, University of California Irvine, Irvine, CA, USACorrespondence: Suleyman Buyukasik, Department of General Surgery, Istanbul Aydin University Faculty of Medicine, Besyol Mah, Akasya Sok. No: 4, Kucukcekmece, Istanbul, 34295, Turkiye, Email [email protected]: This study aimed to evaluate differences in tumor characteristics, molecular subtypes, and surgical approaches between elderly (≥ 70 years) and younger (< 70 years) breast cancer patients.Patients and Methods: This retrospective, single-center study analyzed 120 breast cancer patients (99 younger, 21 elderly) treated surgically between 2020 and 2025 at Istanbul Aydın University, Turkey. Tumor characteristics and surgical management related data were analyzed to compare two age groups. Statistical analyses included t-tests, chi-square tests, and Fisher’s exact tests.Results: Elderly patients presented with significantly larger tumors (3.91± 0.56 vs 2.81± 0.35 cm, p< 0.05), higher T4 disease prevalence (19.05% vs 3.37%, p< 0.05), and greater metastatic burden (7.90± 6.06 vs 3.54± 4.49 metastases, p< 0.05). SLNB was performed significantly more frequently in younger patients (90.9%) compared to elderly patients (71.4%, p < 0.05). Elderly patients underwent axillary dissection in 57.1% of cases compared to 33.3% in younger patients. Advanced tumors (T3+T4) were more prevalent in elderly patients with Luminal B HER2-positive (33.3% vs 0%, p< 0.0001) and Luminal B HER2-negative (37.5% vs 8.3%, p< 0.05) subtypes. Surgical management differed significantly between groups: mastectomy was performed more frequently in elderly patients (57.14% vs 31.31%, p< 0.05), whereas breast-conserving surgery was less common (42.9% vs 67.7%, p< 0.05).Conclusion: These findings demonstrate important differences in disease presentation and surgical management between age groups in Turkey, where breast cancer screening ends at age 69. The absence of screening detection in elderly patients, combined with their advanced disease presentation, highlights the need for further investigation with larger, multicenter cohorts to evaluate optimal screening strategies for women beyond age 69.Keywords: breast cancer, elderly patients, tumor subtypes, surgery, age-related disparities