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. 2021 Oct:59:203-210.
doi: 10.1016/j.breast.2021.07.005. Epub 2021 Jul 9.

Higher-risk breast cancer in women aged 80 and older: Exploring the effect of treatment on survival

Abdulla Al-Rashdan  1 , Yuan Xu  2 , May Lynn Quan  2 , Jeffrey Q Cao  1 , Winson Cheung  3 , Antoine Bouchard-Fortier  4 , Shiying Kong  5 , Lisa Barbera  6
Affiliations

Higher-risk breast cancer in women aged 80 and older: Exploring the effect of treatment on survival

Abdulla Al-Rashdan et al. Breast. 2021 Oct.

Abstract

Background: To understand the association between various treatments and survival for older women with higher-risk breast cancer when controlling for patient and tumor factors.

Materials and methods: We conducted a retrospective, population-based study. Women aged 80 years or older and diagnosed between 2004 and 2017 with non-metastatic, higher-risk breast cancer were identified form the provincial cancer registry in Alberta, Canada. Higher-risk was defined as any of following: T3/4, node positive, human epidermal factor receptor-2 (Her2) positive or triple negative disease. Treatments were surgery, radiotherapy and systemic therapy (hormonal therapy, and/or chemotherapy and/or trastuzumab) or a combination of the previous. Cox regression models were used to examine the association between treatments and breast cancer specific survival (BCSS) and overall survival (OS).

Results: 1369 patients were included. The median age was 84 years. 332 (24%) of women had T3-T4 tumors, 792 (58%) had nodal involvement, 130 (10%) had Her2 positive tumors, 124 (9%) had triple negative tumors. After a median follow-up of 35 months, 29.5% of patients died of breast cancer whereas 34.2% died from other causes. Patients had a lower adjusted hazard for BCSS if they had surgery (hazard ratio [HR] = 0.37 95% confidence interval [CI]: 0.27, 0.51), or systemic therapy (HR = 0.75, 95%CI: 0.58, 0.98). Patients had an increased probability of breast cancer death in the first 5 years after diagnosis compared to death from other causes.

Conclusions: Surgery and systemic therapy were associated with longer BCSS and OS. This suggests that maximizing treatments might benefit higher-risk patients.

Keywords: Breast cancer death; Her2 positive; Locally advanced; Nonagenarians; Octogenarians; Triple negative.

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Conflict of interest statement

Declarations of competing interest LB has received an honorarium from Genentech and travel support from Elekta. Other authors, none.

Figures

Fig. 1
Fig. 1
Consort diagram.
Fig. 2
Fig. 2
Kaplan-Meier curves of breast cancer specific survival (BCSS) and overall survival (OS) for the entire cohort.
Fig. 3
Fig. 3
Cumulative probability of death (breast cancer vs. other causes) by treatment category.
See this image and copyright information in PMC

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