Breast Cancer Research and Treatment

, Volume 147, Issue 3, pp 671–674 | Cite as

A study of ductal versus non-ductal invasive breast carcinomas in older women: long-term clinical outcome and comparison with their younger counterparts

  • J. Mathew
  • S. Lee
  • B. M. Syed
  • D. A. L. Morgan
  • I. O. Ellis
  • K. L. Cheung
Brief Report


Ductal carcinoma is the commonest histological type found in invasive breast carcinomas and may be associated with worse prognosis, when compared to non-ductal carcinoma. Older patients tend to display more favourable tumour biology than younger patients. This study aimed to investigate the significance of histological type and its relationship with clinical outcome in the older group. A total of 808 older (≥70 years) women with early operable primary breast cancer underwent surgery as their primary treatment, followed by optimal adjuvant therapies, in the Nottingham Breast Unit between 1973 and 2009. The histological types of the surgical specimens were reviewed and compared with those in a previously characterised younger (<70 years) series (N = 1,733), in terms of distribution and correlation with clinical outcome. Ductal type was associated with a significantly worse clinical outcome when compared to non-ductal type in the older group in terms of 10-year rates of metastasis-free survival (75 vs 79 %, p = 0.028) and overall survival (44 vs 52 %; p = 0.015). Similar worse clinical outcome was found with the ductal type in the younger group in terms of 10-year rates of metastasis-free survival (65 vs 79 %; p = 0.001) and overall survival (60 vs 78 %; p = 0.001). For all patients with ductal type carcinomas, the older series showed significantly better 10-year metastasis-free survival (75 vs 65 %, p < 0.001) and breast cancer-specific survival (75 vs 69 %, p = 0.025) when compared to the younger series. In both old and the young, ductal cancers were associated with poor survival outcome when compared to non-ductal cancers. When compared to their younger counterparts, older patients with ductal type carcinomas had better metastasis-free and breast cancer-specific survival rates (their lower overall survival was likely to be due to death from other causes), despite having a lower likelihood of receiving adjuvant systemic therapy.


Elderly breast cancer Histological types Prognosis 



We would like to acknowledge all the breast care nurses in the unit for their services in taking care of patients involved in the study.

Conflict of interest

Authors declare that there is no conflict of interest.


  1. 1.
    Cancer incidence and mortality in the United Kingdom and constituent countries, 2004–2006 (2009). Statistical Bulletin, Aug 2009Google Scholar
  2. 2.
    Gannon LM, Cottor MB, Quinn CM et al (2013) The classification of invasive carcinoma of the breast. Expert Rev Anticancer Ther 8:941–954CrossRefGoogle Scholar
  3. 3.
    Cheung KL, Wong WA, Parker H, Li VWY et al (2008) Pathological features of primary breast cancer in the elderly based on needle core biopsies—a large series from a single centre. Crit Rev Oncol Hematol 67:263–267PubMedCrossRefGoogle Scholar
  4. 4.
    Botos A, Csaky G, Minik K (1998) Breast cancer in the elderly. The impact of histological features on the prognosis and survival. Eur J Cancer 34(14):2154–2161CrossRefGoogle Scholar
  5. 5.
    Fisher CJ, Egam MK, Smith P et al (1997) Histopathology of breast cancer in relation to age. Br J Cancer 75(4):593–596PubMedCrossRefPubMedCentralGoogle Scholar
  6. 6.
    Diab SG, Elledge RM, Clark GM (2000) Tumour characteristics and clinical outcome of elderly women with breast cancer. J Natl Cancer Inst 92(7):550–556PubMedCrossRefGoogle Scholar
  7. 7.
    Daidone MG, Coradini D, Martelli G et al (2003) Primary breast cancer in elderly women: biological profile and relation with clinical outcome. Crit Rev Oncol Haematol 45:313–325CrossRefGoogle Scholar
  8. 8.
    Djordjevic N, Karanikolic A, Pesic M (2004) Breast cancer in elderly women. Arch Gerontol Geriatr 39:291–299PubMedCrossRefGoogle Scholar
  9. 9.
    Pierga JY, Girre V, Laurence V et al (2004) Characteristics and outcome of 1755 operable breast cancers in women over 70 years of age. Breast 5(13):369–375CrossRefGoogle Scholar
  10. 10.
    Li CI, Uribe DJ, Daling JR (2005) Clinical characteristics of different histologic types of breast cancer. Br J Cancer 93:1046–1052PubMedCrossRefPubMedCentralGoogle Scholar
  11. 11.
    Maa C-D, Zhoub Q, Nie X-Q et al (2009) Breast cancer in Chinese elderly women: pathological and clinical characteristics and factors influencing treatment patterns. Crit Rev Oncol Hematol 71:258–265CrossRefGoogle Scholar
  12. 12.
    Albrektsen G, Heuch I et al (2010) Histological type and grade of breast cancer tumors by parity, age at birth, and time since birth: a register-based study in Norway. BMC Cancer 10:226PubMedCrossRefPubMedCentralGoogle Scholar
  13. 13.
    Townsley CA, Selby R, Siu LL (2005) Systematic review of barriers to the recruitment of older patients with cancer onto clinical trials. J Clin Oncol 23:3112–3124PubMedCrossRefGoogle Scholar
  14. 14.
    Syed BM, Johnson SJ, Wong DWM et al (2012) Long-term (37 years) clinical outcome of older women with early operable primary breast cancer managed in a dedicated clinic. Ann Oncol 6:1465–1471CrossRefGoogle Scholar
  15. 15.
    Barchelli A, Balzi D (2000) Age at diagnosis, extent of disease and breast cancer survival: a population-based study in Florence, Italy. Tumori 86:119–123Google Scholar
  16. 16.
    Abd El-Rehim DM, Ball G, Pinder SE et al (2005) High-throughput protein expression analysis using tissue microarray technology of a large well-characterised series identifies biologically distinct classes of breast cancer confirming recent cDNA expression analyses. Int J Cancer 116(3):340–350PubMedCrossRefGoogle Scholar
  17. 17.
    Elston C, Ellis I (1991) Pathological prognostic factors in breast cancer: the value of histological grade in breast cancer: experience from a large study with long-term follow-up. Histopathology 19(5):403–410PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • J. Mathew
    • 1
  • S. Lee
    • 1
  • B. M. Syed
    • 1
  • D. A. L. Morgan
    • 2
  • I. O. Ellis
    • 1
  • K. L. Cheung
    • 1
  1. 1.School of Medicine, Royal Derby Hospital CentreUniversity of NottinghamDerbyUK
  2. 2.Department of OncologyNottingham University HospitalsNottinghamUK

Personalised recommendations