Mª D Torregrosa1,2, M J Escudero3, I Paredero4, E Carrasco3, B Bermejo3,5,6, J Gavila3,7, J García-Saenz3,6,8, A Santaballa3,9, P Martínez3,10, A Llombart3,11, R Andrés3,12, N Batista3,13, A Fernández3,14, A Antón3,15, M Seguí3,16, S Gonzalez3,17, A Ruiz3,7. 1. Medical Oncology Department, Hospital Universitario Dr. Peset, Avda Gaspar Aguilar 90, 46017, Valencia, Spain. marilotorre@gmail.com. 2. GEICAM, Spanish Breast Cancer Group, Madrid, Spain. marilotorre@gmail.com. 3. GEICAM, Spanish Breast Cancer Group, Madrid, Spain. 4. Medical Oncology Department, Hospital Universitario Dr. Peset, Avda Gaspar Aguilar 90, 46017, Valencia, Spain. 5. Hospital Clínico Universitario de Valencia, Instituto de Investigación Sanitaria INCLIVA, Universitat de Valencia, Madrid, Spain. 6. Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Valencia, Spain. 7. Instituto Valenciano de Oncología, Valencia, Spain. 8. Hospital Clínico Universitario San Carlos, Madrid, Spain. 9. Hospital Universitario La Fe, Valencia, Spain. 10. Hospital de Basurto, Bilbao, Spain. 11. Hospital Universitario de Lleida Arnau de Vilanova, Lleida, Spain. 12. Hospital Universitario Lozano Blesa, Zaragoza, Spain. 13. Hospital Universitario de Canarias. Universidad de La Laguna, La Laguna, Spain. 14. Complejo Hospitalario de Albacete, Albacete, Spain. 15. Hospital General Universitario Miguel Servet, Zaragoza, Spain. 16. Corporació Sanitaria Parc Taulli (Sabadell), Barcelona, Spain. 17. Hospital Mutua de Terrassa, Barcelona, Spain.
Abstract
INTRODUCTION: An increase in the number of cancer cases is expected in the near future. Breast cancer (BC) mortality rates increase with age even when adjusted for other variables. Here we analyzed BC disease-free survival (BCDFS) and BC specific survival (BCSS) in the El Alamo III BC registry of GEICAM Spanish Breast Cancer Group. MATERIALS AND METHODS: El Alamo III is a retrospective registry of BC patients diagnosed between 1998 and 2001. Patients with stage I-III invasive BC of age groups 55-64 years (y), 70-74 years and ≥ 75 years were included. Patients and tumors characteristics, treatments and recurrences and deaths were analyzed. RESULTS: 4343 patients were included within the following age intervals: 2288 (55-64 years), 960 (70-74 years), and 1095 (≥ 75 years). Older patients (≥ 70 years) were diagnosed with more advanced tumors (stage III) than younger patients (21.5% versus 13.4%, p < 0.0001). Mastectomies were performed more on older patients and they received less chemotherapy than younger patients (66.6% versus 43.1%, p < 0.00001 and 30.8% versus 71.6%, p < 0.0001, respectively). With a median follow-up of 5.9 years, 17.7% patients had BCDFS events in the younger group and 19.8% in the older group (p < 0.0001). A decrease in BCSS was also observed in older patients, either when analyzing patients ≥ 70y (p < 0.0001) and when differentiating by the two older groups (p < 0.0001). CONCLUSIONS: Our study suggests that older BC patients have worse outcomes what can be a consequence of receiving inadequate adjuvant treatments. Specific trials for these patients are warranted to allow us to treat them with the same scientific rigor than younger patients.
INTRODUCTION: An increase in the number of cancer cases is expected in the near future. Breast cancer (BC) mortality rates increase with age even when adjusted for other variables. Here we analyzed BC disease-free survival (BCDFS) and BC specific survival (BCSS) in the El Alamo III BC registry of GEICAM Spanish Breast Cancer Group. MATERIALS AND METHODS: El Alamo III is a retrospective registry of BC patients diagnosed between 1998 and 2001. Patients with stage I-III invasive BC of age groups 55-64 years (y), 70-74 years and ≥ 75 years were included. Patients and tumors characteristics, treatments and recurrences and deaths were analyzed. RESULTS: 4343 patients were included within the following age intervals: 2288 (55-64 years), 960 (70-74 years), and 1095 (≥ 75 years). Older patients (≥ 70 years) were diagnosed with more advanced tumors (stage III) than younger patients (21.5% versus 13.4%, p < 0.0001). Mastectomies were performed more on older patients and they received less chemotherapy than younger patients (66.6% versus 43.1%, p < 0.00001 and 30.8% versus 71.6%, p < 0.0001, respectively). With a median follow-up of 5.9 years, 17.7% patients had BCDFS events in the younger group and 19.8% in the older group (p < 0.0001). A decrease in BCSS was also observed in older patients, either when analyzing patients ≥ 70y (p < 0.0001) and when differentiating by the two older groups (p < 0.0001). CONCLUSIONS: Our study suggests that older BC patients have worse outcomes what can be a consequence of receiving inadequate adjuvant treatments. Specific trials for these patients are warranted to allow us to treat them with the same scientific rigor than younger patients.
Entities:
Keywords:
Adjuvant treatment; Early breast cancer; Older patients; Survival; Undertreatment
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