Skip to main content
Top
Published in: Clinical and Translational Oncology 12/2019

01-12-2019 | Breast Cancer | Research Article

Evolution of older patients diagnosed with early breast cancer in Spain between 1998 and 2001 included in El Alamo III project

Authors: Mª D. Torregrosa, M. J. Escudero, I. Paredero, E. Carrasco, B. Bermejo, J. Gavila, J. García-Saenz, A. Santaballa, P. Martínez, A. Llombart, R. Andrés, N. Batista, A. Fernández, A. Antón, M. Seguí, S. Gonzalez, A. Ruiz, On behalf of GEICAM, the Spanish Breast Cancer Group

Published in: Clinical and Translational Oncology | Issue 12/2019

Login to get access

Abstract

Introduction

An increase in the number of cancer cases is expected in the near future. Breast cancer (BC) mortality rates increase with age even when adjusted for other variables. Here we analyzed BC disease-free survival (BCDFS) and BC specific survival (BCSS) in the El Alamo III BC registry of GEICAM Spanish Breast Cancer Group.

Materials and methods

El Alamo III is a retrospective registry of BC patients diagnosed between 1998 and 2001. Patients with stage I–III invasive BC of age groups 55–64 years (y), 70–74 years and ≥ 75 years were included. Patients and tumors characteristics, treatments and recurrences and deaths were analyzed.

Results

4343 patients were included within the following age intervals: 2288 (55–64 years), 960 (70–74 years), and 1095 (≥ 75 years). Older patients (≥ 70 years) were diagnosed with more advanced tumors (stage III) than younger patients (21.5% versus 13.4%, p < 0.0001). Mastectomies were performed more on older patients and they received less chemotherapy than younger patients (66.6% versus 43.1%, p < 0.00001 and 30.8% versus 71.6%, p < 0.0001, respectively). With a median follow-up of 5.9 years, 17.7% patients had BCDFS events in the younger group and 19.8% in the older group (p < 0.0001). A decrease in BCSS was also observed in older patients, either when analyzing patients ≥ 70y (p < 0.0001) and when differentiating by the two older groups (p < 0.0001).

Conclusions

Our study suggests that older BC patients have worse outcomes what can be a consequence of receiving inadequate adjuvant treatments. Specific trials for these patients are warranted to allow us to treat them with the same scientific rigor than younger patients.
Literature
2.
go back to reference Galceran J, et al. Cancer incidence in Spain, 2015. Clin Transl Oncol. 2017;19(7):799–825.CrossRef Galceran J, et al. Cancer incidence in Spain, 2015. Clin Transl Oncol. 2017;19(7):799–825.CrossRef
4.
go back to reference van de Water W, et al. Association between age at diagnosis and disease-specific mortality among postmenopausal women with hormone receptor-positive breast cancer. JAMA. 2012;307(6):590–7.PubMed van de Water W, et al. Association between age at diagnosis and disease-specific mortality among postmenopausal women with hormone receptor-positive breast cancer. JAMA. 2012;307(6):590–7.PubMed
5.
go back to reference Schonberg MA, et al. Causes of death and relative survival of older women after a breast cancer diagnosis. J Clin Oncol. 2011;29(12):1570–7.CrossRef Schonberg MA, et al. Causes of death and relative survival of older women after a breast cancer diagnosis. J Clin Oncol. 2011;29(12):1570–7.CrossRef
6.
go back to reference Vallet-Regi M, et al. Management of cancer in the older age person: an approach to complex medical decisions. Oncologist. 2017;22(3):335–42.CrossRef Vallet-Regi M, et al. Management of cancer in the older age person: an approach to complex medical decisions. Oncologist. 2017;22(3):335–42.CrossRef
7.
go back to reference Barcenas CH, et al. Risk of hospitalization according to chemotherapy regimen in early-stage breast cancer. J Clin Oncol. 2014;32(19):2010–7.CrossRef Barcenas CH, et al. Risk of hospitalization according to chemotherapy regimen in early-stage breast cancer. J Clin Oncol. 2014;32(19):2010–7.CrossRef
8.
go back to reference Lichtman SM, et al. International Society of Geriatric Oncology Chemotherapy Taskforce: evaluation of chemotherapy in older patients—an analysis of the medical literature. J Clin Oncol. 2007;25(14):1832–43.CrossRef Lichtman SM, et al. International Society of Geriatric Oncology Chemotherapy Taskforce: evaluation of chemotherapy in older patients—an analysis of the medical literature. J Clin Oncol. 2007;25(14):1832–43.CrossRef
9.
go back to reference Malik MK, Tartter PI, Belfer R. Undertreated breast cancer in the elderly. J Cancer Epidemiol. 2013;2013:893104.CrossRef Malik MK, Tartter PI, Belfer R. Undertreated breast cancer in the elderly. J Cancer Epidemiol. 2013;2013:893104.CrossRef
10.
go back to reference Ayodele O, et al. Comparing attitudes of younger and older patients towards cancer clinical trials. J Geriatr Oncol. 2016;7(3):162–8.CrossRef Ayodele O, et al. Comparing attitudes of younger and older patients towards cancer clinical trials. J Geriatr Oncol. 2016;7(3):162–8.CrossRef
11.
go back to reference Talarico L, Chen G, Pazdur R. Enrollment of elderly patients in clinical trials for cancer drug registration: a 7-year experience by the US Food and Drug Administration. J Clin Oncol. 2004;22(22):4626–31.CrossRef Talarico L, Chen G, Pazdur R. Enrollment of elderly patients in clinical trials for cancer drug registration: a 7-year experience by the US Food and Drug Administration. J Clin Oncol. 2004;22(22):4626–31.CrossRef
12.
go back to reference Clegg A, et al. Frailty in elderly people. Lancet. 2013;381(9868):752–62.CrossRef Clegg A, et al. Frailty in elderly people. Lancet. 2013;381(9868):752–62.CrossRef
13.
go back to reference Hurria A, et al. Predicting chemotherapy toxicity in older adults with cancer: a prospective multicenter study. J Clin Oncol. 2011;29(25):3457–65.CrossRef Hurria A, et al. Predicting chemotherapy toxicity in older adults with cancer: a prospective multicenter study. J Clin Oncol. 2011;29(25):3457–65.CrossRef
14.
go back to reference Mama GGEDIECD. Proyecto El Álamo III. Encuesta de evolución de pacientes con cáncer de mama en hospitales del grupo GEICAM (1998 –2001). 2014, Madrid: Comuniland S.L. Mama GGEDIECD. Proyecto El Álamo III. Encuesta de evolución de pacientes con cáncer de mama en hospitales del grupo GEICAM (1998 –2001). 2014, Madrid: Comuniland S.L.
15.
go back to reference Bastiaannet E, et al. Breast cancer in elderly compared to younger patients in the Netherlands: stage at diagnosis, treatment and survival in 127,805 unselected patients. Breast Cancer Res Treat. 2010;124(3):801–7.CrossRef Bastiaannet E, et al. Breast cancer in elderly compared to younger patients in the Netherlands: stage at diagnosis, treatment and survival in 127,805 unselected patients. Breast Cancer Res Treat. 2010;124(3):801–7.CrossRef
16.
go back to reference Siu AL, U.S. Preventive Services Task Force. Screening for breast cancer: U.S. preventive services task force recommendation statement. Ann Intern Med. 2016;164(4):279–96.CrossRef Siu AL, U.S. Preventive Services Task Force. Screening for breast cancer: U.S. preventive services task force recommendation statement. Ann Intern Med. 2016;164(4):279–96.CrossRef
17.
go back to reference de Kruijf EM, et al. Comparison of frequencies and prognostic effect of molecular subtypes between young and elderly breast cancer patients. Mol Oncol. 2014;8(5):1014–25.CrossRef de Kruijf EM, et al. Comparison of frequencies and prognostic effect of molecular subtypes between young and elderly breast cancer patients. Mol Oncol. 2014;8(5):1014–25.CrossRef
18.
go back to reference Bouchardy C, et al. Undertreatment strongly decreases prognosis of breast cancer in elderly women. J Clin Oncol. 2003;21(19):3580–7.CrossRef Bouchardy C, et al. Undertreatment strongly decreases prognosis of breast cancer in elderly women. J Clin Oncol. 2003;21(19):3580–7.CrossRef
19.
go back to reference Blair SRJ, Weiss A, Ward E, Unkart J. Treatment of breast cancer in women aged 80 and older: a systematic review. Breast Can Curr Res. 2016;1:115. Blair SRJ, Weiss A, Ward E, Unkart J. Treatment of breast cancer in women aged 80 and older: a systematic review. Breast Can Curr Res. 2016;1:115.
20.
go back to reference Muss HB, et al. Adjuvant chemotherapy in older women with early-stage breast cancer. N Engl J Med. 2009;360(20):2055–65.CrossRef Muss HB, et al. Adjuvant chemotherapy in older women with early-stage breast cancer. N Engl J Med. 2009;360(20):2055–65.CrossRef
21.
go back to reference Freyer G, et al. Adjuvant docetaxel/cyclophosphamide in breast cancer patients over the age of 70: results of an observational study. Crit Rev Oncol Hematol. 2011;80(3):466–73.CrossRef Freyer G, et al. Adjuvant docetaxel/cyclophosphamide in breast cancer patients over the age of 70: results of an observational study. Crit Rev Oncol Hematol. 2011;80(3):466–73.CrossRef
22.
go back to reference Chen HL, et al. Effect of age on breast cancer patient prognoses: a population-based study using the SEER 18 database. PLoS ONE. 2016;11(10):e0165409.CrossRef Chen HL, et al. Effect of age on breast cancer patient prognoses: a population-based study using the SEER 18 database. PLoS ONE. 2016;11(10):e0165409.CrossRef
Metadata
Title
Evolution of older patients diagnosed with early breast cancer in Spain between 1998 and 2001 included in El Alamo III project
Authors
Mª D. Torregrosa
M. J. Escudero
I. Paredero
E. Carrasco
B. Bermejo
J. Gavila
J. García-Saenz
A. Santaballa
P. Martínez
A. Llombart
R. Andrés
N. Batista
A. Fernández
A. Antón
M. Seguí
S. Gonzalez
A. Ruiz
On behalf of GEICAM, the Spanish Breast Cancer Group
Publication date
01-12-2019
Publisher
Springer International Publishing
Published in
Clinical and Translational Oncology / Issue 12/2019
Print ISSN: 1699-048X
Electronic ISSN: 1699-3055
DOI
https://doi.org/10.1007/s12094-019-02189-6

Other articles of this Issue 12/2019

Clinical and Translational Oncology 12/2019 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine