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

Abstract

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

The Association between Age, Comorbidities and Use of Radiotherapy in Women with Breast Cancer: Implications for Survival

“…There is no consensus in the literature regarding the age cut-off point for older women, limiting comparison of our results with other studies [ 35 ]. Although NCDB is the most comprehensive collection of breast cancer data in the United States, it may underrepresent priority populations such as those lacking comprehensive health insurance [ 36 ].…”

Guideline-concordant chemotherapy in patients with hormone receptor-positive and node-positive, early breast cancer leads to better overall and metastases-free survival with limited benefit in elderly patients

“…In the adjuvant setting of the SENORA project, 75.1% of all patients aging < 70 years received chemotherapy. In contrast to this, only 66.2% of patients aging ≥ 70 have undergone chemotherapy [16]. As mentioned above, age at diagnosis has a strong impact on the decision of The evidence of better overall survival in chemotherapytreated patients being < 70 years of age in comparison to not-treated patients is clearly shown in this analysis.…”

Comorbidities, age and period of diagnosis influence treatment and outcomes in early breast cancer

“…Furthermore, more advanced stage at diagnosis and lower stage‐specific survival characterised women ≥75 years compared to younger women . Studies on European women with early BC diagnosed in 1996–1998, and German women diagnosed 2007–2015, found that older patients received standard treatments less often than younger patients . Comorbidities at diagnosis, patient choice, and resource availability are all likely to influence whether or not standard treatments are given, thus influencing outcomes …”