HISTOPATHOLOGY OF BREAST-CANCER IN RELATION TO AGE

Histological reports of 1869 consecutive women with invasive breast ca ncer have been reviewed to determine whether histological features of the tumours were related to the patients' age. The patients, treated b etween 1983 and 1992, were divided into four groups, based on age. The re were 148 aged less than or equal to 39 years, 355 aged 40-49 years, 984 aged 50-69 years and 382 aged 70 years or more. The most outstand ing finding was the increase in incidence of grade III infiltrating du ctal carcinoma in those aged less than or equal to 39 years (P<0.0001) . Certain tumour types, in particular lobular, were reported more freq uently in the oldest age group. Additionally, there was a significant reduction of axillary lymph node metastases, vascular invasion and lym phoplasmacytic stromal reaction with increasing age, ail of which were independent of tumour grade. These data suggest that there may be age -related changes in the histology of breast cancer and, in some cases, less aggressive features in the elderly However, as the life expectan cy of women over the age of 70 may be many years, treatment should be based on histological prognostic features of the primary tumour rather than age alone.