Age-related disparities in older women with breast cancer

Bagegni, Nusayba A.; Peterson, Lindsay L.

doi:10.1016/bs.acr.2020.01.003

Cited by 20 publications

(15 citation statements)

References 120 publications

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Section: Discussionmentioning

confidence: 99%

“…Advanced age is the major risk factor for breast cancer and is regarded as a significant independent predictor of poor breast cancer prognosis [20,21]. Nearly one third of all patients diagnosed with breast cancer are 70 years of age or older [20]. In fact, a US woman of average risk who is and has been free of breast cancer until 75 still has a 5.2% probability of developing breast cancer during her lifetime [18].…”

Section: Discussionmentioning

confidence: 99%

“…Not all elderly women can tolerate the negative effects of chemotherapy or even radiotherapy, and polypharmacy has been associated with increased chemotherapy toxicity. Anthracyclines and CMF are currently being replaced by anthracyclineand taxane-containing regimens [20,21]. Breast irradiation should be offered to older women with a life expectancy of more than 5 years, with large tumours, positive lymph nodes, or negative hormone receptors [15].…”

Section: Discussionmentioning

confidence: 99%

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Clinicopathological characteristics in women with breast cancer in extreme ages in Greece: A single centre experience

Karachalios

Karamitrousis

Daskalakis

2021

Forum of Clinical Oncology

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Introduction Breast cancer is the most common malignancy in Greek women. The highest incidence occurs in patients aged 40–70 years. However, the emergence of the disease in women under 40 and over 80 years old is a significant problem in everyday practice, because of the diagnostic and therapeutic challenges for these age groups. The objective of this study is to investigate clinicopathological characteristics of Greek women under 40 and over 80 diagnosed with breast cancer during 2019–2020 in a specialized Breast Cancer Surgical Centre, as well as the pathological characteristics of their disease and the therapeutic measures applied to these women. Aim of the study The aim of this study is to compare clinical and pathological characteristics of breast cancer in a group of Greek premenopausal women younger than 40 years of age with a group of elderly women older than 80 years old, who were treated in a surgical breast centre in Greece during the last two years. Patients and Methods During the last 2 years, 21 women under 40 and 22 women older than 80 were diagnosed with breast cancer in our Centre. Results Invasive ductal adenocarcinoma was the most frequent histological type for both Groups: Most younger women underwent surgery followed by chemotherapy, while the majority of older patients received hormonal therapy after surgery. Conclusions There were no statistically significant differences between women under 40 and women over 80 in the study sample regarding their clinicopathological characteristics. However, younger women underwent more therapeutic modalities (i.e.adjuvant treatments in addition to surgery) than older ones.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Clinicopathological characteristics in women with breast cancer in extreme ages in Greece: A single centre experience

Karachalios

Karamitrousis

Daskalakis

2021

Forum of Clinical Oncology

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“…Increasing evidence suggests that health outcomes including symptom burden are worse in oncology patients with health disparities ( National Cancer Institute, 2020 ). Age is one of the factors that can lead to worse health outcomes in women with breast cancer ( Chen et al, 2016 ; Bagegni and Peterson, 2020 ). In studies of patients with heterogeneous types of cancer, findings regarding age are disparate, with several reports ( Cataldo et al, 2013 ; Ritchie et al, 2014 ; Miaskowski et al, 2015 ) demonstrating that younger age was associated with higher symptom severity and lower quality of life.…”

Section: Introductionmentioning

confidence: 99%

Differences in Circulating Extracellular Vesicle and Soluble Cytokines in Older Versus Younger Breast Cancer Patients With Distinct Symptom Profiles

et al. 2022

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Because extracellular vesicle (EV)-associated cytokines, both encapsulated and surface bound, have been associated with symptom severity, and may vary over the lifespan, they may be potential biomarkers to uncover underlying mechanisms of various conditions. This study evaluated the associations of soluble and EV-associated cytokine concentrations with distinct symptom profiles reported by 290 women with breast cancer prior to surgery. Patients were classified into older (≥60 years, n = 93) and younger (< 60 years, n = 197) cohorts within two previously identified distinct symptom severity profiles, that included pain, depressive symptoms, sleep disturbance, and fatigue (i.e., High Fatigue Low Pain and All Low). EVs were extracted using ExoQuick. Cytokine concentrations were determined using Luminex multiplex assay. Mann Whitney U test evaluated the differences in EV and soluble cytokine levels between symptom classes and between and within the older and younger cohorts adjusting for Karnofsky Performance Status (KPS) score, body mass index (BMI), and stage of disease. Partial correlation analyses were run between symptom severity scores and cytokine concentrations. Results of this study suggest that levels of cytokine concentrations differ between EV and soluble fractions. Several EV and soluble pro-inflammatory cytokines had positive associations with depressive symptoms and fatigue within both age cohorts and symptom profiles. In addition, in the older cohort with High Fatigue Low Pain symptom profile, EV GM-CSF concentrations were higher compared to the All Low symptom profile (p < 0.05). Albeit limited by a small sample size, these exploratory analyses provide new information on the association between cytokines and symptom profiles of older and younger cohorts. Of note, unique EV-associated cytokines were found in older patients and in specific symptom classes. These results suggest that EVs may be potential biomarker discovery tools. Understanding the mechanisms that underlie distinct symptom class profiles categorized by age may inform intervention trials and offer precision medicine approaches.

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“…It is reported that almost half of breast cancer-speci c deaths occur in female patients aged 70 or over. [2] A 2019 study about global cancer incidence estimated that the number of newly diagnosed cancer in the elderly population would be double by 2035, from 2.8 to 5.7 million among elderly females. By 2035, 58% of the total cancer incidence globally will happen in older people.…”

Section: Introductionmentioning

confidence: 99%

The Trade-Off of Post-Mastectomy Radiotherapy Usage for the Breast Cancer Patients Aged 70 Years or Older: A Study Based on SEER Database

Lin

Luo

Zhang

et al. 2021

Preprint

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Introduction: This study aimed to investigate the role of post-mastectomy radiotherapy (PMRT) in the female aged 70 years or older diagnosed with breast cancer, which is still controversial.Methods: This retrospective study enrolled women aged 70+ years diagnosed with breast cancer between 2004 and 2016 following mastectomy from the Surveillance, Epidemiology, and End Results (SEER) database. Propensity score matching (PSM) was performed to reduce covariable imbalance. A nomogram was created to predict the 1,3,5-years overall survival (OS) of elderly patients based on the the univariable and multivariable COX regression model results. The X-tile software determined the optimal cutoff value of risk scores from the nomogram and divided patients into three risk groups. Results: Of the 27,636 females were eligible, 17.2% (n=4,747) received PMRT while 82,8% (n=22889) not. After 1:1 matching, PMRT were associated with significant improvement in breast cause-specific survival (BCSS) and OS (p <0.001). By contrast, the BCSS and OS benefit from PMRT were not significant in patients with T1N1 tumor (BCSS：HR = 0.716，p = 0.249；OS：HR = 0.908，p = 0.572), and T2N1 tumor (BCSS：HR = 0.866，p = 0.289；OS：HR = 0.879，p = 0.166). Stratified by subtype, the HR+/HER-2- subtype and the HR-/HER-2- subtype (all p<0.001) have a significant prolonged survival, yet not significant difference are shown in the HER-2+ tumor. The nomogram has high predictive accuracy and discrimination, and well distinguish three risk groups. In the low-risk group, PMRT didn't significantly better OS (p=0.203).Conclusions: This study demonstrated that post-mastectomy radiotherapy improves the survival of females with elderly breast cancer. After a comprehensive assessment of the side effects and the quality of life, the omission of PMRT could be considered in patients with T1-2N1 breast cancer. Furthermore, the nomogram we constructed could be used as a decision tool for the omission of PMRT in low-risk elderly patients.

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Age-related disparities in older women with breast cancer

Cited by 20 publications

References 120 publications

Clinicopathological characteristics in women with breast cancer in extreme ages in Greece: A single centre experience

Clinicopathological characteristics in women with breast cancer in extreme ages in Greece: A single centre experience

Differences in Circulating Extracellular Vesicle and Soluble Cytokines in Older Versus Younger Breast Cancer Patients With Distinct Symptom Profiles

The Trade-Off of Post-Mastectomy Radiotherapy Usage for the Breast Cancer Patients Aged 70 Years or Older: A Study Based on SEER Database

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