CANCER DU SEIN CHEZ LA FEMME ?G?E : EXPERIENCE DU SERVICE D?ONCO-RADIOTH?RAPIE CHU DE MARRAKECH BREAST CANCER IN ELDERLY WOMEN: EXPERIENCE OF THE SERVICE OF ONCO-RADIOTHERAPY UNIVERSITY HOSPITAL OF MARRAKECH

Our objective was to analyze the epidemiological, clinical, therapeutic and prognostic of breast cancer in older women. We performed a retrospective study of 35 cases of breast cancer among older women treated and followed in the oncology radiotherapy department of the University Hospital Mohammed VI Marrakech, in over a period of 5 years from 2012 to 2016.Among 603 women who had breast cancer during the study period, 35 were aged 65 and over, or 5,8 %. The average age of these patients was 72-year-old. The mean time for diagnosis was 15 months. A breast nodule was the main sign in 91,42% of cases, associated with inflammatory signs in five cases. The majority of tumors were classified T3 (51,43%) forms classified T4 represented 25,42 % of the tumors. Ipsilateral axillary lymph nodes found in 14 patients or 40 % of cases. The disease was metastatic at diagnosis in 5 cases. Infiltrative ductal carcinoma represented 88,57%. It was in 74,28% of cases of grade II Scarff-Bloom and Richardson (SBR), and 25,72% grade III. The lymph node was positive in 22 patients(62,85%). The expression of HR was noted in 74,28% of cases. HER2 was over expressed in 14,28% of cases. Surgical treatment was performed after neo adjuvant chemotherapy in 7 cases of locally advanced cancers, three patients underwent conservative treatment, while 31 patients underwent a mastectomy with lymphnode dissection, associated with radiation therapy in 77,14% of cases and a profit analgesic radiotherapy in 2 patients. Adjuvant Chemotherapy was prescribed for 20 patients. 74,28% of the patients received hormonal therapy. Trastuzumab was given in 11,42% of cases. The evolution was marked by a complete remission after a decline of a year in 20 cases, 5 patients had progressive disease after a mean of ten months. Conclusion: The age factor is not to be alone a criterion for treatment decisions, understanding the multiple facets of the physical and psychological health of the patient and the medical, social and family should be taken into account.