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. 2022 Dec:66:24-30.
doi: 10.1016/j.breast.2022.09.001. Epub 2022 Sep 6.

Treatment and survival outcomes in older women with primary breast cancer: A retrospective propensity score-matched analysis

Yuting Sang  1 , Benlong Yang  2 , Miao Mo  3 , Shiyang Liu  1 , Xujie Zhou  1 , Jiajian Chen  2 , Shuang Hao  2 , Xiaoyan Huang  2 , Guangyu Liu  1 , Zhimin Shao  1 , Jiong Wu  4
Affiliations

Treatment and survival outcomes in older women with primary breast cancer: A retrospective propensity score-matched analysis

Yuting Sang et al. Breast. 2022 Dec.

Abstract

Purpose: Changes in biological features and functional status make management decisions in older women with primary breast cancer complicated. We aimed to provide an overview of the clinicopathological characteristics and survival outcomes of older breast cancer patients based on the current treatment strategies.

Methods: Female patients diagnosed with primary invasive breast cancer at Fudan University Shanghai Cancer Centre from 2008 to 2016 were included. Patients were divided into a younger group (<65 years) and older group (≥65 years). Propensity score matching was utilised to generate balanced cohorts.

Results: A total of 13,707 patients met the study criteria. Compared with younger patients, older patients had a higher Charlson Comorbidity Index (p < 0.001), less lymph node metastasis (p = 0.009), more advanced tumour stage (p = 0.038), and a larger proportion of estrogen receptor-positive (p < 0.001) and epidermal growth factor receptor 2-negative (p < 0.001) tumours. Older patients were likely to receive mastectomy and axillary lymph node dissection in addition to a lower proportion of adjuvant chemotherapy. Adjuvant chemotherapy (HR [hazard ratio] 0.69, p = 0.039) was independently correlated with better overall survival in the older patients. This survival benefit (HR 0.58, p = 0.041) was confirmed in matched cohorts. Among the older patients with larger tumours (HR 0.48, p = 0.038) and more lymph node involvement (HR 0.44, p = 0.040), adjuvant chemotherapy was associated with a significant survival benefit.

Conclusion: Older breast cancer patients showed less aggressive biological characteristics, intensive surgical and moderate medical preferences. The addition of adjuvant chemotherapy should be considered for older patients, especially for patients with large tumours and more lymph node involvement.

Keywords: Breast cancer; Clinicopathological features; Older women; Survival outcomes; Treatment strategy.

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Conflict of interest statement

Declaration of competing interest None.

Figures

Fig. 1
Fig. 1
Kaplan-Meier plots for overall survival in the matched cohort of patients with (N = 224) and without (N = 224) adjuvant chemotherapy.
Fig. 2
Fig. 2
Subgroup analysis of impact factors in propensity score-matched cohort (N = 448).
See this image and copyright information in PMC

References

    1. Cao W., Chen H.D., Yu Y.W., Li N., Chen W.Q. Changing profiles of cancer burden worldwide and in China: a secondary analysis of the global cancer statistics 2020. Chin Med J (Engl). 2021;134:783–791. - PMC - PubMed
    1. Chen W., Zheng R., Baade P.D., Zhang S., Zeng H., Bray F., et al. Cancer statistics in China, 2015. CA Cancer J Clin. 2016;66:115–132. - PubMed
    1. Lei S., Zheng R., Zhang S., Chen R., Wang S., Sun K., et al. Cancer Biol Med; 2021. Breast cancer incidence and mortality in women in China: temporal trends and projections to 2030. - PMC - PubMed
    1. Fan L., Strasser-Weippl K., Li J.J., St Louis J., Finkelstein D.M., Yu K.D., et al. Breast cancer in China. Lancet Oncol. 2014;15:e279–e289. - PubMed
    1. Fan L., Zheng Y., Yu K.D., Liu G.Y., Wu J., Lu J.S., et al. Breast cancer in a transitional society over 18 years: trends and present status in Shanghai, China. Breast Cancer Res Treat. 2009;117:409–416. - PubMed