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Breast Cancer Research and Treatment
Published in: Breast Cancer Research and Treatment 1/2019

Open Access 01-11-2019 | Geriatric Oncology | Epidemiology

Improved survival of older patients with advanced breast cancer due to an increase in systemic treatments: a population-based study

Authors: Nienke de Glas, Esther Bastiaannet, Anna de Boer, Sabine Siesling, Gerrit-Jan Liefers, Johanneke Portielje

Published in: Breast Cancer Research and Treatment | Issue 1/2019

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Abstract

Purpose

The number of older patients with breast cancer is rapidly increasing. A previous study showed that between 1990 and 2005, the survival of older patients with breast cancer did not improve in contrast to younger patients. In recent years, scientific evidence in the older age group has increased and specific guidelines for older women with breast cancer have been developed. The aim of this study was to assess changes in survival outcomes of older patients with breast cancer.

Patients and methods

All patients with breast cancer between 2000 and 2017 were included from the Netherlands cancer registry. We assessed changes in treatments using logistic regression. We calculated changes in relative survival as proxy for breast cancer mortality, stratified by age and stage.

Results

We included 239,992 patients. Relative survival improved for patients < 65 for all stages. In patients aged 65–75 years, relative survival did not improve in stage I–II but did improve in stage III breast cancer (RER 0.98, 95% CI 0.96–1.00, p = 0.046). Concurrently, prescription of systemic treatments increased. In patients > 75, relative survival did not improve in patients with stage I/II or stage III disease, nor did treatment strategies change.

Conclusions

This study shows that relative survival of patients aged 65–75 years with advanced breast cancer has improved, and concurrently, prescription of systemic treatment increased. To improve survival of patients > 75 as well, future studies should focus on individualizing treatments based on concomitant comorbidity, geriatric parameters and the risk of competing mortality and toxicity of treatments.
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Metadata
Title
Improved survival of older patients with advanced breast cancer due to an increase in systemic treatments: a population-based study
Authors
Nienke de Glas
Esther Bastiaannet
Anna de Boer
Sabine Siesling
Gerrit-Jan Liefers
Johanneke Portielje
Publication date
01-11-2019
Publisher
Springer US
Published in
Breast Cancer Research and Treatment / Issue 1/2019
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-019-05356-z

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