Locally advanced breast cancer in elderly patients

Hornová, J; Bortlíček, Zbyněk; Májková, Petra; Abrahámová, Jitka; Kordíková, D.; Donátová, Zuzana; Kupec, Martin; Boublíková, Ludmila; Dvořák, Josef; Zapletal, Radek; Büchler, Tomáš

doi:10.5507/bp.2017.011

Cited by 9 publications

(10 citation statements)

References 18 publications

(20 reference statements)

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“…It showed that patients who were ≥80 years had a worse OS, with a median of 31.6 months (19.0-44.3) (HR 2.55, 95% CI 1.40-4.65, P = 0.002), than did patients who were <80 years, with a median of 78.5 months (51.4-105.5). Moreover, multivariate analysis also confirmed the significance of older age on OS in patients in the group who were ≥80 years (HR 4.76, 95% CI 1.22−18.61, P = 0.025) [ 17 ].…”

Section: Discussionmentioning

confidence: 87%

“…Data in the literature about the impact of a patient's age on the prognosis of BC are contradictory. Some authors reported that younger patients have a worse prognosis, whereas other authors reported elderly patients as having the worst prognosis [15][16][17][18][19][20][21]. Moreover, previous data in the United States, the United Kingdom, and KSA did not show any significant impact of patient age on OS and progression-free survival (PFS) in LABC [9,22,23].…”

Section: Discussionmentioning

confidence: 99%

“…These contradictory results could be attributed to the lack of fixed age cutoffs to define these groups (young vs elderly) among the studies. [17].…”

Section: Discussionmentioning

confidence: 99%

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Locally Advanced Breast Cancer: Treatment Patterns and Predictors of Survival in a Saudi Tertiary Center

Trabulsi¹,

Shabkah²,

Ujaimi³

et al. 2021

Cureus

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BackgroundBreast cancer (BC) is the most common cancer in the Kingdom of Saudi Arabia (KSA) and the second leading cause of cancer-related mortality. About 40% of BC in KSA is locally advanced BC (LABC), which has been associated with poorer survival compared with early diagnosed BC. ObjectiveTo review the presentation and outcomes of LABC, including the characteristics of the disease, different treatment modalities, overall survival (OS), disease-free survival (DFS), and local recurrence in relation to different radiotherapy (RT) techniques. MethodsWe retrospectively reviewed the medical records of 153 female patients with pathologically proven LABC diagnosed at King Abdulaziz University Hospital, Jeddah, KSA, between 2009 and 2017. We obtained data on patient demographics, stage of cancer at diagnosis, tumor characteristics (subtype and receptor status), type of surgery, systemic treatments received (hormonal, targeted therapy, and chemotherapy), RT variables, and recurrence and death dates. Data were analyzed to assess OS and DFS by using Kaplan-Meier analyses and the log-rank test. Univariate and multivariate Cox proportional hazard regression analyses were used to explore and identify factors associated with survival. ResultsThe median survival time in the study population was 9.16 years. Older age (65+ years) was associated with worse OS and DFS than was younger age (<65 years) (hazard ratio (HR) 3.20, 95% CI 1.48-6.90, P = 0.003 and HR 2.21, 95% CI 1.12-4.36, P = 0.022, respectively). Regarding the type of surgery, having a mastectomy was associated with worse OS and DFS than was having a lumpectomy (HR 2.44, 95% CI 0.97-6.12, P = 0.05 and HR 2.41, 95% CI 1.13-5.14, P = 0.023, respectively). Positive estrogen and progesterone receptor status was associated with better OS and DFS than was a negative estrogen or progesterone receptor status (HR 0.13, 95% CI 0.05-0.30, P < 0.001 and HR 0.21, 95% CI 0.11-0.41, P < 0.001, respectively). Patients who received RT had a lower risk of recurrence than did those who did not receive RT (P = 0.011). Moreover, threedimensional conformal RT was associated with lower local recurrence than intensity-modulated RT or volumetric-modulated arc therapy (P = 0.003). ConclusionMultiple factors can affect the OS and DFS in LABC. Younger patients, having hormone-positive disease, and undergoing lumpectomy were associated with better outcomes. Adjuvant RT may improve local control and the use of three-dimensional conformal RT was superior for local control. Prospective studies with larger sample sizes are needed to further highlight these findings and to assess the role of chemotherapy and targeted therapy in patients with LABC.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

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Locally Advanced Breast Cancer: Treatment Patterns and Predictors of Survival in a Saudi Tertiary Center

Trabulsi¹,

Shabkah²,

Ujaimi³

et al. 2021

Cureus

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“…Currently, LABC is still predominantly multidisciplinary comprehensive treatment, 1 , 2 , 11 , 19 yet this pattern is not going well in elderly patients. 7 First, elderly patients were not suitable for surgery or difficult to operate immediately because of their age, medical comorbidities or poor compliance, and even if they underwent surgery, complications such as upper limb edema could cause great suffering. 7 Although radiotherapy and chemotherapy were effective in elderly LABC, they were sometimes abandoned because they were poorly tolerated or mobility.…”

Section: Discussionmentioning

confidence: 99%

Development and Validation a Survival Prediction Model and a Risk Stratification for Elderly Locally Advanced Breast Cancer

Meng¹,

Chang²,

Wang³

et al. 2022

Clinical Breast Cancer

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“…Each of these parameters holds the potential to affect decision for treatment in a facility with or without DKG-certi cate, beyond that multifactor interaction needs to be considered. For instance, elderly women with breast cancer present more frequently with advanced disease [13]. Thus, adjusted logistic regression was performed to take potential interaction between all analyzed parameters into account.…”

Section: Introductionmentioning

confidence: 99%

Factors Stimulating Treatment in a Certified Breast or Prostate Cancer Center

Schirrmacher

Hamann

Justenhoven

2022

Preprint

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The German Cancer Society (DKG) offers certification of oncological centres since 2003. Meanwhile more than 260 and more than 120 certified centres for breast and prostate cancer, respectively, exist in Germany. Aim of the herein performed investigation was the identification of factors that stimulate treatment of patients with breast or prostate cancer in a certified centre. This study was based on information available in the database of the Cancer Registry of Rhineland-Palatinate, Germany. The impact of age, region of residence, tumor status, grading and presence of metastasis on patient’s decision with respect to a certain medical facility was analyzed by adjusted logistic regression. This investigation included data of 13,020 breast cancer and 10,904 prostate cancer patients diagnosed in the years 2016 to 2020. Overall, 59 % and 28 % of breast and prostate cancer patients, respectively, were treated in a DKG-certified centre. The analyses showed that residence in an urban region was associated with treatment in a certified centre (breast: OR 0.42, 95% CI (0.37-0.48); prostate: OR 0.46 95% CI (0.40-0.53)). In addition, older breast cancer patients were more often treated in hospitals without certificate (OR 1.13, 95% CI (1.04-1.24). Prostate cancer showed no association with age but early tumor stage (T1) were more often treated in hospitals without certificate (OR 1.23, 95% CI (1.03-1.46). In contrast, patients with more advanced tumors, T2 and T3, were likely to be reported by DKG-certified centres (OR 0.58, 95% CI (0.41-0.81) and OR 0.67, 95% CI (0.47-0.96), respectively). Most breast and more than a quarter of prostate cancer patients were treated in DKG-certified centres. The region of residence seemed to affect the decision for a certain facility for all patients. Whereas age at diagnosis and tumor status played a role for breast and prostate cancer patients, respectively.

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Locally advanced breast cancer in elderly patients

Cited by 9 publications

References 18 publications

Locally Advanced Breast Cancer: Treatment Patterns and Predictors of Survival in a Saudi Tertiary Center

Locally Advanced Breast Cancer: Treatment Patterns and Predictors of Survival in a Saudi Tertiary Center

Development and Validation a Survival Prediction Model and a Risk Stratification for Elderly Locally Advanced Breast Cancer

Factors Stimulating Treatment in a Certified Breast or Prostate Cancer Center

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