Treatment of elderly breast cancer patients in a breast center in India

Reddy, Asha; Mullapudi, Naga Amulya; Kabeer, Kirti Katherine; Nimmagadda, Ramesh; Selvi, Radhakrishna

doi:10.4103/ijc.ijc_237_18

Cited by 5 publications

(4 citation statements)

References 20 publications

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“…None of the factors like tumor size, nodal status, stage of BC, histological subtype, grade, molecular subtypes, hormonal receptor positivity, and Charlson comorbidity index showed any significance in our study. In a study from India by Reddy et al, 5 receptor positivity was observed in 79% of elderly patients and 9% had triple-negative disease that was similar to our study showing 75% of hormone receptor positivity and triple negativity in 19.6%. Our patients received chemotherapy in 83% including neoadjuvant and adjuvant chemotherapy and 7.1% had dose reduction in chemotherapy due to toxicities.…”

Section: Discussionsupporting

confidence: 91%

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Survival Outcome and Predictors of Survival in Elderly Breast Cancer Patients following Curative Treatment

T.M,

Joseph P,

K.R

et al. 2023

South Asian J Cancer

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Background The lack of data on management of elderly breast cancer patients' population makes most oncologists reluctant to treat them with the standard treatment protocols as advised for the younger patients. This study was done to identify the survival outcome and predictors of survival in elderly breast cancer patients treated with curative intent. Methodology Newly diagnosed patients with breast cancer aged more than 65 years who received treatment with curative intent were included. Disease-free survival (DFS) and overall survival were estimated using the Kaplan–Meier method. Survival curves were compared using log-rank test. Cox regression analysis was done to find out the predictors of DFS. Results This study included 112 elderly breast cancer patients. In our patient population, 79 (70.5%) were less than or equal to 70 years of age and 33 (29.5%) were more than or equal to 70 years. Median age was 68 years. Charlson comorbidity index score was six and above in 31 (28.1) patients. Median DFS in our study was 46 months. Median DFS was not reached in patients less than or equal to 70 years of age, whereas it was 50 months (47–53) among patients more than or equal to 70 years of age, p-value-0.009. In univariate analysis, age more than or equal to 70 years and locally advanced breast cancer were the predictors of DFS with hazard ratio (HR) of 2.8 (1.2–6.69), p-value 0.013 and 2.9 (1.12–7.6), and 0.027, respectively. In multivariate analysis, age more than or equal to 70 years was the only significant predictors of DFS with HR of 2.8 (1.2–6.5) and p-value of 0.015. Conclusion Standard curative intent treatment was well tolerable among elderly patents. Elderly age more than 70 years was a unique predictor of DFS. We need to incorporate tools to assess life expectancy and functional status that will help us predict toxicity of treatment and survival advantage more precisely.

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Section: Discussionsupporting

confidence: 91%

“…About 8.9% (10) patients were nulliparous and 91.1% (102) were multiparous. Family history of BC was seen in 4.6% (5). Major comorbidities were hypertension in 56.3% (63), diabetes 44.6% (50), coronary artery disease 5.4% (6), hypothyroidism 5.4% ( 6), chronic liver disease 1.8% (2), dyslipidemia 1.8% (2), and bronchial asthma in 3.6% (4).…”

Section: Resultsmentioning

confidence: 99%

Survival Outcome and Predictors of Survival in Elderly Breast Cancer Patients following Curative Treatment

T.M,

Joseph P,

K.R

et al. 2023

South Asian J Cancer

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“…Our findings are in line with another study and revealed that diagnosis of stage II or III BC was more prevalent (39.2%) among individuals aged >80 [ 85 ]. Another study also supports our findings that elder women usually had stage II or III BC [ 86 ]. One may ask the reason why stage II and III BC is more prevalent in the present study.…”

Section: Discussionsupporting

confidence: 89%

Geriatric Breast Cancer: Staging, Molecular Surrogates, and Treatment. A Review & Meta-analysis

Fonseca,

Sidiropoulou

2023

Aging and disease

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Breast cancer (BC) is one of the most frequent cancers in females across the globe. Treatment recommendations for BC patients are primarily driven by patient age, staging and tumor molecular subtype. Thus, we updated the general overview of BC staging, molecular surrogates, and treatment choices for women >70 years based on a systematic study encompassing the years 2013-2023. A PRISMA guidelines and PICO framework were followed, and relevant research articles were searched using different data bases (Web of Sciences, PubMed, MEDLINE, and Scopus). Mixed Methods Appraisal Tool was used for studies quality assessment. The research articles that made it into the systematic review were compiled using qualitative criteria. In the meanwhile, heterogeneity was determined using meta-analysis with RevMan 5.4. We applied a random effects model with a 0.05 significance level. Overall, there were 4151 research articles, after screening only 17 articles with 39,906 patients were included. Conclusion: Elderly patients with breast cancer should be treated differently in an adapted way. The treatment should not be the same worldwide due to different health systems. Molecular surrogates are different in geriatric patients. Surgery is the best option for treatment in this subset of patients. We need to have therapeutic decision appointments for elderly patients with breast cancer. The guidelines and medical authority should be used in the best decision.

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“…Though cases experienced worse pain, other symptoms were similar in either of the groups. Extension and adduction strength were inferior in patients with (9).…”

Section: Discussionmentioning

confidence: 77%

A prospective case-control study of disability, quality of life, and functional impairment of shoulder movements after latissimus dorsi myocutaneous flap reconstruction in breast cancer patients

Nanda Singh,

Suryavanshi,

Ahmad

et al. 2024

Turk J Surg

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Objective: Dysfunction of shoulder movements could be a limiting factor to the use of Latissimus dorsi (LD) flap. This study aimed to assess the impact of LD flap reconstruction on shoulder dysfunction and the quality of life. Material and Methods: This study comprised 28 early breast cancer cases who underwent breast conserving surgery (BCS) with LD flap and 40 controls. Subjective and objective assessments were done a year later. Results: Mild and moderate disability were found in 85.71% and 14.3% cases vs. 100% and 0% controls (p= 0.316) respectively. Physical and emotional functioning were 84.29 ± 5.61 and 66.67 ± 6.05 in cases vs. 86.67 ± 8.38 and 70.0 ± 6.84 in controls (p= 0.36, 0.23) respectively. Pain score in cases was 23.8 ± 15.6 vs. 12.17 ± 8.4 in controls (p= 0.018). LD muscle strength in extension was 4.39 ± 0.35 in cases vs. 4.88 ± 0.22 in controls (p< 0.001), 4.43 ± 0.18 for adduction in cases vs. 4.65 ± 0.24 in controls (p= 0.006). ROM of shoulder in flexion was 151.61 ± 4.86° in cases and 153.88 ± 2.36° in controls (p= 0.08), 40.36 ± 3.52° in cases vs. 49.13 ± 1.86° in controls for extension (p< 0.001), in abduction it was 150.54 ± 3.69° in cases vs. 150.00 ± 0.00° in controls (p= 0.518), in adduction was 30.89 ± 4.0° in cases vs. 38.13 ± 1.11° in controls (p< 0.001), in external rotation was 73.57 ± 3.63° in cases vs. 77.63 ± 2.36° in controls (p< 0.001), and internal rotation was 69.46 ± 3.56° in cases vs. 79.00 ± 1.26° in controls (p< 0.001). Conclusion: We conclude that functional impairment should not be a determining factor for LD flap in breast reconstruction surgery.

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Treatment of elderly breast cancer patients in a breast center in India

Cited by 5 publications

References 20 publications

Survival Outcome and Predictors of Survival in Elderly Breast Cancer Patients following Curative Treatment

Survival Outcome and Predictors of Survival in Elderly Breast Cancer Patients following Curative Treatment

Geriatric Breast Cancer: Staging, Molecular Surrogates, and Treatment. A Review & Meta-analysis

A prospective case-control study of disability, quality of life, and functional impairment of shoulder movements after latissimus dorsi myocutaneous flap reconstruction in breast cancer patients

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