AGO Recommendations for the Diagnosis and Treatment of Patients with Early Breast Cancer: Update 2016

Liedtke, Cornelia; Thill, Marc

doi:10.1159/000446941

Cited by 98 publications

(19 citation statements)

References 62 publications

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“…The 3-year OS of patients with MS was 82.9%, in patients without MS -84.6%, and the 5-year OS were 70.7% and 80.6%, respectively (Table 5). Consequently, 1-, 3-, and 5-year OS in BC patients with MS was lower than in patients without MS, but statistically significant differences were detected regarding only 5-year survival rates, which confirms the data of other researchers [13,14]. So, OS in elderly and young patients with MS was significantly lower than in patients without MS.…”

Section: Relation Between Survival Rates and Molecular Subtype Of Bcsupporting

confidence: 87%

Analysis of the Survival of Patients With Breast Cancer Depending on Age, Molecular Subtype of Tumor and Metabolic Syndrome

2018

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Aim: To analyze the survival of patients with breast cancer (BC) depending on age, molecular subtype of the tumor and the presence of metabolic syndrome. Patients and Methods: We have analyzed the results of examination and treatment of 202 patients with BC of stages I–III. The patients were distributed by age into 2 groups. The group 1 included 86 elderly patients (from 65 to 84 years old), the group 2 — 116 younger patients (from 32 to 64 years). An overall 1-, 3- and 5-year survival rates of the treated patients were assessed. The significance of factors influencing the overall survival (OS) of patients with BC was determined using the methods of statistical analysis. Results: Molecular subtype of BC significantly affects survival rates: in a case of a luminal B subtype the 5-year OS was 71.6% vs 80% (p < 0.05) in groups 1 and 2, respectively while in a case of a basal-like subtype it was 60.2% and 71.6% (p < 0.05). The presence of metabolic syndrome significantly reduced the 5-year OS (up to 70.7% and 80.6%, p < 0.05 in groups 1 and 2, respectively). Conclusion: The OS is lower in elderly patients with BC compared with younger patients, especially in those who suffer from metabolic syndrome.

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Section: Relation Between Survival Rates and Molecular Subtype Of Bcsupporting

confidence: 87%

Analysis of the Survival of Patients With Breast Cancer Depending on Age, Molecular Subtype of Tumor and Metabolic Syndrome

2018

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“…The TBCRC 020 trial found that only 1% of LCIS and/or ALH on CNB with concordant imaging examination were upgraded on surgical samples, suggesting that surgical excision is not indicated in these cases when accurately diagnosed [ 13 ]. In line with this, European international recommendations [ 14 ] recently proposed to reserve open surgery for LN, mainly in cases of radio-pathological discordance [ 4 , 15 ]. The LN WHO classification system is closely related to the risk of upgrade.…”

Section: Discussionmentioning

confidence: 99%

The lobular neoplasia enigma: management and prognosis in a long follow-up case series

et al. 2021

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Background Many oncologists debate if lobular neoplasia (LN) is a risk factor or an obligatory precursor of more aggressive disease. This study has three aims: (i) describe the different treatment options (surgical resection vs observation), (ii) investigate the upgrade rate in surgically treated patients, and (iii) evaluate the long-term occurrences of aggressive disease in both operated and unoperated patients. Methods A series of 122 patients with LN bioptic diagnosis and follow-up information were selected. Clinical, radiological, and pathological data were collected from medical charts. At definitive histology, either invasive or ductal carcinoma in situ was considered upgraded lesions. Results Atypical lobular hyperplasia (ALH), lobular carcinoma in situ (LCIS), and high-grade LN (HG-LN) were diagnosed in 44, 63, and 15 patients, respectively. The median follow-up was 9.5 years. Ninety-nine patients were surgically treated, while 23 underwent clinical-radiological follow-up. An upgrade was observed in 28/99 (28.3%). Age ≥ 54 years (OR 4.01, CI 1.42–11.29, p = 0.009), Breast Imaging-Reporting and Data System (BI-RADS) categories 4–5 (OR 3.76, CI 1.37–10.1, p = 0.010), and preoperatory HG-LN diagnosis (OR 8.76, 1.82–42.27, p = 0.007) were related to upgraded/aggressive disease. During follow-up, 8 patients developed an ipsilateral malignant lesion, four of whom were not initially operated (4/23, 17%). Conclusions BI-RADS categories 4–5, HG-LN diagnosis, and age ≥ 54 years were features associated with an upgrade at definitive surgery. Moreover, 17% of unoperated cases developed an aggressive disease, emphasizing that LN patients need close surveillance due to the long-term risk of breast cancer.

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“…Consistent with these reports, 26% of the elderly patients in the SENORA cohort were initially diagnosed with tumour stage III compared to 14% of the younger patients. The finding that patients aged > 70 more frequently present with more advanced tumours might be a consequence of recommendations for screening mammograms, which have only been established for the age groups between 50 and 70 years [ 27 ]. The HR-positive tumours, however, were equally distributed over the age groups.…”

Section: Discussionmentioning

confidence: 99%

Routine treatment and outcome of breast cancer in younger versus elderly patients: results from the SENORA project of the prospective German TMK cohort study

Fietz¹,

Zahn²,

Köhler

et al. 2017

Breast Cancer Res Treat

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received endocrine therapy and less frequently chemotherapy. Their median overall survival [24.9 months, 95% CI (confidence interval) 20.0-30.2] was significantly shorter than that of younger patients (39.7 months, 95% CI 34.9-44.2). A Cox proportional hazards model showed a significantly increased risk of mortality for: age ≥ 70 at start of therapy, negative HR-or HER2-status, higher number of metastatic sites, more comorbidities and high tumour grading at diagnosis. Conclusions Our results shed light on the routine treatment of elderly patients with breast cancer. A regression model demonstrated that age is but one of various prognostic factors determining the shorter overall survival of elderly patients.Keywords Breast neoplasms · Aged · Registries · Cohort studies · Outcome assessment · Prognosis AbstractPurpose There is an ongoing discussion about 'undertreatment' of breast cancer in elderly patients. Due to low accrual into clinical trials, level 1 evidence is scarce. We report prospective data of elderly patients with breast cancer treated by medical oncologists in Germany. Methods The SENORA project within the prospective cohort study TMK (Tumour Registry Breast Cancer) was conducted in 82 centres from 2007-2015. Among 2316 patients, half were enrolled with curative and half with palliative treatment intention. Overall, 478 patients (21%) were aged ≥ 70. Results In the adjuvant setting, elderly patients aged ≥ 70 had more advanced tumour stages at diagnosis and a higher prevalence of comorbidities than younger patients. Elderly patients received adjuvant chemotherapy less frequently, yet the 3-year disease-free survival was similar (86% vs. 88%). In the palliative setting, elderly patients more frequently * Norbert Marschner

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AGO Recommendations for the Diagnosis and Treatment of Patients with Early Breast Cancer: Update 2016

Abstract: on behalf of the AGO Breast Committee

Cited by 98 publications

References 62 publications

Analysis of the Survival of Patients With Breast Cancer Depending on Age, Molecular Subtype of Tumor and Metabolic Syndrome

Analysis of the Survival of Patients With Breast Cancer Depending on Age, Molecular Subtype of Tumor and Metabolic Syndrome

The lobular neoplasia enigma: management and prognosis in a long follow-up case series

Routine treatment and outcome of breast cancer in younger versus elderly patients: results from the SENORA project of the prospective German TMK cohort study

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