目的：分析70 岁以上女性乳腺癌患者的临床病理特征、治疗方式及预后影响因素。方法：回顾2007 年1 月—2010 年12 月哈尔滨医科大学附属肿瘤医院乳腺外科接诊并接受手术治疗的203 例70 岁以上老年女性乳腺癌患者的临床资料，分析其临床病理特点及生存情况。结果：203 例患者中，临床TNM I 期患者67 例（33.0%），II 期患者117 例（57.6%）；无腋窝淋巴结转移患者92 例（53.5%）；浸润性导管癌166 例（81.8%），为主要病理类型；177 例行免疫组织化学检查，ER、PR 阳性与HER-2 过表达患者分别为123 例（69.5%）、114 例（64.4%）、23 例（13.0%）；乳腺癌改良根治术153 例（75.4%），为主要手术方式；术后接受内分泌治疗患者111 例（54.7%），化疗患者28 例（13.8%）。单因素分析显示年龄、淋巴结状态、ER、PR、组织学分级与内分泌治疗与患者总生存时间（OS）有关，淋巴结状态、ER、PR、HER-2、内分泌治疗与化疗与患者无病生存时间（DFS）有关（均P<0.05）；COX 多因素分析显示年龄、淋巴结状态和PR 为OS 的独立影响因素，淋巴结状态为DFS 的独立影响因素（均P<0.05）。结论：老年女性乳腺癌具有独特生物学特性，主要治疗方式为手术治疗。年龄、淋巴结状态和PR 是老年女性乳腺癌的独立预后因素。
Analysis of clinicopathologic profiles and prognosis of breast cancer in women over 70 years of age
Objective: To investigate the clinicopathologic features, treatment patterns and prognostic factors in female breast cancer patients over 70 years of age. Methods: The clinical 203 female breast cancer patients over 70 admitted and undergoing surgical treatment in the Department of Breast Surgery, the Third Affiliated Hospital of Harbin Medical University from January 2007 to December 2010 were reviewed. The clinical features and prognosis of the patients were analyzed. Results: Of the 203 patients, 67 cases (33.0%) had TNM stage I and 117 cases (57.6%) had TNM stage II disease and 92 cases (53.5%) had no axillary lymph node metastasis; 166 cases (81.8%) were invasive ductal carcinoma which was the main pathological type. Immunohistochemical staining showed that ER and PR expression, and HER-2 overexpression was found in 123 cases (69.5%), 114 cases (64.4%), and 23 cases (13.0%) respectively. Of the patients, 153 cases (75.4%) underwent modified radical mastectomy that was the main surgical type, and 111 cases (54.7%) received endocrine therapy and 28 cases (13.8%) had chemotherapy after operation. Univariate analysis showed the overall survival (OS) was associated with age, lymph node status, ER, PR, histological grade and endocrine therapy of the patients, and disease-free survival (DFS) was related to lymph node status, ER, PR, HER-2, endocrine therapy and chemotherapy (all P<0.05); multivariate COX analysis indicated that age, lymph node status and PR were independent prognostic factors for OS, while lymph node status was an independent prognostic factor for DFS (all P<0.05). Conclusion: Breast cancer in elderly patients has distinct biological characteristics, and surgery is the main treatment method. Age, lymph node status and PR are independent prognostic factors for these patients.