Skip to main content
Top
Published in: BMC Cancer 1/2012

Open Access 01-12-2012 | Research article

Population-based study of breast cancer in older women: prognostic factors of relative survival and predictors of treatment

Authors: Pegdwende Olivia Dialla, Tienhan Sandrine Dabakuyo, Sophie Marilier, Julie Gentil, Patrick Roignot, Ariane Darut-Jouve, Marie-Laure Poillot, Valérie Quipourt, Patrick Arveux

Published in: BMC Cancer | Issue 1/2012

Login to get access

Abstract

Background

A large proportion of women with breast cancer (BC) are elderly. However, there is a lack of information regarding BC prognostic factors and care in this population. The aims of this study were to assess the prognostic factors of relative survival (RS) among women with BC aged ≥ 75 years old and to identify the predictive factors of treatments administered to this population.

Methods

A population-based study was performed using data from the Cote d’Or breast and gynaecological cancer registry. Women aged 75 years and older with primary invasive BC and resident in Cote d’Or at the time of diagnosis made between January 1998 and December 2008 were retrospectively selected. Prognostic factors of RS were estimated in a generalized linear model with a Poisson error structure. RS rate for the whole population was given at 5 years. Logistic regression models were used to identify the predictors of the treatments administered.

Results

Six hundred and eighty-one women were included. Median age at diagnosis was 80. Comorbidities (p=0.02), pT stage (p=0.04), metastases (p=<0.001), having a family doctor (p=0.03) and hormone-receptor status (p=0.006) were independent prognostic factors of RS. The RS rate at 5 years for the whole population was 78.2%, 95%CI = [72.2-83.0]. Age, pT stage, metastases, histoprognostic SBR grade, hormone receptor status and comorbidities were frequently found to be predictors of treatment with surgery alone, hormone therapy alone, breast conserving surgery plus adjuvant therapy and mastectomy plus adjuvant therapy.

Conclusions

Comorbid conditions adversely affect survival in older women with breast cancer. Moreover the results of this study showed that there are numerous predictors of the type of treatment administered, and that the most important were age and comorbidities.
Appendix
Available only for authorised users
Literature
1.
go back to reference Boyle P, Ferlay J: Cancer incidence and mortality in Europe 2004. Ann Oncol. 2005, 16: 481-488. 10.1093/annonc/mdi098.CrossRefPubMed Boyle P, Ferlay J: Cancer incidence and mortality in Europe 2004. Ann Oncol. 2005, 16: 481-488. 10.1093/annonc/mdi098.CrossRefPubMed
2.
go back to reference Colonna M, Danzon A, De Lafosse P, Mitton N, Bara S, Bouvier A-M, Ganry O, Guizard A-V, Launoy G, Molinie F, Sauleau E-A, Schvartz C, Velten M, Grosclaude P, Tretarre B: Cancer prevalence in France: time trend, situation in 2002 and extrapolation to 2012. Eur J Cancer. 2008, 44: 115-122. 10.1016/j.ejca.2007.10.022.CrossRefPubMed Colonna M, Danzon A, De Lafosse P, Mitton N, Bara S, Bouvier A-M, Ganry O, Guizard A-V, Launoy G, Molinie F, Sauleau E-A, Schvartz C, Velten M, Grosclaude P, Tretarre B: Cancer prevalence in France: time trend, situation in 2002 and extrapolation to 2012. Eur J Cancer. 2008, 44: 115-122. 10.1016/j.ejca.2007.10.022.CrossRefPubMed
3.
go back to reference Belot A, Grosclaude P, Bossard N, Jougla E, Benhamou E, Delafosse P, Guizard AV, Molinié F, Danzon A, Bara S, Bouvier AM, Trétarre B, Binder-Foucard F, Colonna M, Daubisse L, Hédelin G, Launoy G, Le Stang N, Maynadié M, Monnereau A, Troussard X, Faivre J, Collignon A, Janoray I, Arveux P, Buemi A, Raverdy N, Schvartz C, Bovet M, Chérié-Challine L, Estève J, Remontet L, Velten M: Cancer incidence and mortality in France over the period 1980-2005. Rev Epidemiol Sante Publique. 2008, 56: 159-175. 10.1016/j.respe.2008.03.117.CrossRefPubMed Belot A, Grosclaude P, Bossard N, Jougla E, Benhamou E, Delafosse P, Guizard AV, Molinié F, Danzon A, Bara S, Bouvier AM, Trétarre B, Binder-Foucard F, Colonna M, Daubisse L, Hédelin G, Launoy G, Le Stang N, Maynadié M, Monnereau A, Troussard X, Faivre J, Collignon A, Janoray I, Arveux P, Buemi A, Raverdy N, Schvartz C, Bovet M, Chérié-Challine L, Estève J, Remontet L, Velten M: Cancer incidence and mortality in France over the period 1980-2005. Rev Epidemiol Sante Publique. 2008, 56: 159-175. 10.1016/j.respe.2008.03.117.CrossRefPubMed
4.
go back to reference La situation du cancer en France en 2011: Collection rapports et synthèses, ouvrage collectif Edité par l’INCa. 2011, Boulogne-Billancourt La situation du cancer en France en 2011: Collection rapports et synthèses, ouvrage collectif Edité par l’INCa. 2011, Boulogne-Billancourt
5.
go back to reference Kim KJ, Huh SJ, Yang JH, Park W, Nam SJ, Kim JH, Lee JH, Kang SS, Lee JE, Kang MK, Park YJ, Nam HR: Treatment results and prognostic factors of early breast cancer treated with a breast conserving operation and radiotherapy. Jpn J Clin Oncol. 2005, 35: 126-133. 10.1093/jjco/hyi039.CrossRefPubMed Kim KJ, Huh SJ, Yang JH, Park W, Nam SJ, Kim JH, Lee JH, Kang SS, Lee JE, Kang MK, Park YJ, Nam HR: Treatment results and prognostic factors of early breast cancer treated with a breast conserving operation and radiotherapy. Jpn J Clin Oncol. 2005, 35: 126-133. 10.1093/jjco/hyi039.CrossRefPubMed
6.
go back to reference Dabakuyo TS, Bonnetain F, Roignot P, Poillot M-L, Chaplain G, Altwegg T, Hedelin G, Arveux P: Population-based study of breast cancer survival in Cote d'Or (France): prognostic factors and relative survival. Ann Oncol. 2008, 19: 276-283. 10.1093/annonc/mdm491.CrossRefPubMed Dabakuyo TS, Bonnetain F, Roignot P, Poillot M-L, Chaplain G, Altwegg T, Hedelin G, Arveux P: Population-based study of breast cancer survival in Cote d'Or (France): prognostic factors and relative survival. Ann Oncol. 2008, 19: 276-283. 10.1093/annonc/mdm491.CrossRefPubMed
7.
go back to reference Andrieu JM, Colonna P: Cancers: évaluation, traitement et surveillance. 1997, Ed ESTEM, Paris Andrieu JM, Colonna P: Cancers: évaluation, traitement et surveillance. 1997, Ed ESTEM, Paris
8.
go back to reference DiGiovanna MP: Clinical significance of HER-2/neu overexpression: Part I. Principles and practice of oncology. volume 13. Edited by: DeVita VT Jr, Hellman S, Rosenberg SA. 1999, Lippincott Williams & Wilkins Cedar Knolls, NJ, 9 DiGiovanna MP: Clinical significance of HER-2/neu overexpression: Part I. Principles and practice of oncology. volume 13. Edited by: DeVita VT Jr, Hellman S, Rosenberg SA. 1999, Lippincott Williams & Wilkins Cedar Knolls, NJ, 9
9.
go back to reference Huiart L, Bardou V-J, Puig B, Maraninchi D: Improvement in breast cancer survival between 1975 and 2003 in a cohort of 5722 women. Bull Cancer. 2006, 93: 391-399.PubMed Huiart L, Bardou V-J, Puig B, Maraninchi D: Improvement in breast cancer survival between 1975 and 2003 in a cohort of 5722 women. Bull Cancer. 2006, 93: 391-399.PubMed
10.
go back to reference Goldhirsch A, Ingle JN, Gelber RD, Coates AS, Thürlimann B, Senn H-J, Panel members: Thresholds for therapies: highlights of the St Gallen intenational expert consensus on the primary therapy of early breast cancer 2009. Ann Oncol. 2009, 20: 1319-1329. 10.1093/annonc/mdp322.CrossRefPubMedPubMedCentral Goldhirsch A, Ingle JN, Gelber RD, Coates AS, Thürlimann B, Senn H-J, Panel members: Thresholds for therapies: highlights of the St Gallen intenational expert consensus on the primary therapy of early breast cancer 2009. Ann Oncol. 2009, 20: 1319-1329. 10.1093/annonc/mdp322.CrossRefPubMedPubMedCentral
12.
go back to reference Grosclaude P, Colonna M, Hedelin G, Tretarre B, Arveux P, Lesec’h JM, Raverdy N, Sauvage-Machelard M: Survival of women with breast cancer in France: variation with age, stage and treatment. Breast Cancer Res Treat. 2001, 70: 137-143. 10.1023/A:1012974728007.CrossRefPubMed Grosclaude P, Colonna M, Hedelin G, Tretarre B, Arveux P, Lesec’h JM, Raverdy N, Sauvage-Machelard M: Survival of women with breast cancer in France: variation with age, stage and treatment. Breast Cancer Res Treat. 2001, 70: 137-143. 10.1023/A:1012974728007.CrossRefPubMed
13.
go back to reference Bouchardy C, Rapiti E, Fioretta G, Laissue P, Neyroud-Caspar I, Schäfer P, Kurtz J, Sappino A-P, Vlastos G: Undertreatment strongly decreases prognosis of breast cancer in elderly women. J Clin Oncol. 2003, 21: 3580-3587. 10.1200/JCO.2003.02.046.CrossRefPubMed Bouchardy C, Rapiti E, Fioretta G, Laissue P, Neyroud-Caspar I, Schäfer P, Kurtz J, Sappino A-P, Vlastos G: Undertreatment strongly decreases prognosis of breast cancer in elderly women. J Clin Oncol. 2003, 21: 3580-3587. 10.1200/JCO.2003.02.046.CrossRefPubMed
14.
go back to reference Van Leeuwen BL, Rosenkranz KM, Lei Feng L, Bedrosian I, Hartmann K, Hunt KK, Kuerer HM, Ross M, Singletary SE, Babiera GV, the Department of Surgical Oncology, MD Anderson Cancer Center: The effect of under-treatment of breast cancer in women 80 years of age and older. Crit Rev Oncol Hematol. 2011, 79: 315-320. 10.1016/j.critrevonc.2010.05.010.CrossRefPubMed Van Leeuwen BL, Rosenkranz KM, Lei Feng L, Bedrosian I, Hartmann K, Hunt KK, Kuerer HM, Ross M, Singletary SE, Babiera GV, the Department of Surgical Oncology, MD Anderson Cancer Center: The effect of under-treatment of breast cancer in women 80 years of age and older. Crit Rev Oncol Hematol. 2011, 79: 315-320. 10.1016/j.critrevonc.2010.05.010.CrossRefPubMed
15.
go back to reference Hughes KS, Schnaper LA, Berry D, Cirrincione C, McCormick B, Shank B, Wheeler J, Champion LA, Smith TJ, Smith BL, Shapiro C, Muss HB, Winer E, Hudis C, Wood W, Sugarbaker D, Henderson IC, Norton L: Lumpectomy plus tamoxifen with or without irradiation in women 70 years of age or older with early breast cancer. N Engl J Med. 2004, 351: 971-977. 10.1056/NEJMoa040587.CrossRefPubMed Hughes KS, Schnaper LA, Berry D, Cirrincione C, McCormick B, Shank B, Wheeler J, Champion LA, Smith TJ, Smith BL, Shapiro C, Muss HB, Winer E, Hudis C, Wood W, Sugarbaker D, Henderson IC, Norton L: Lumpectomy plus tamoxifen with or without irradiation in women 70 years of age or older with early breast cancer. N Engl J Med. 2004, 351: 971-977. 10.1056/NEJMoa040587.CrossRefPubMed
16.
go back to reference Early Breast Cancer Trialists’ Collaborative Group (EBCTCG): Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials. Lancet. 2005, 365: 1687-1717.CrossRef Early Breast Cancer Trialists’ Collaborative Group (EBCTCG): Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials. Lancet. 2005, 365: 1687-1717.CrossRef
17.
go back to reference Mandelblaltt J, Kreling B, Figeuriedo M, Feng S: What is the impact of shared decision making on treatment and outcomes for older women with breast cancer?. J Clin Oncol. 2006, 24: 4908-4913. 10.1200/JCO.2006.07.1159.CrossRef Mandelblaltt J, Kreling B, Figeuriedo M, Feng S: What is the impact of shared decision making on treatment and outcomes for older women with breast cancer?. J Clin Oncol. 2006, 24: 4908-4913. 10.1200/JCO.2006.07.1159.CrossRef
18.
go back to reference Bouchardy C, Rapiti E, Blagojevic S, Vlastos A-T, Vlastos G: Older female cancer patients: importance, causes, and consequences of undertreatment. J Clin Oncol. 2007, 25: 1858-1869. 10.1200/JCO.2006.10.4208.CrossRefPubMed Bouchardy C, Rapiti E, Blagojevic S, Vlastos A-T, Vlastos G: Older female cancer patients: importance, causes, and consequences of undertreatment. J Clin Oncol. 2007, 25: 1858-1869. 10.1200/JCO.2006.10.4208.CrossRefPubMed
19.
go back to reference Giordano SH, Hortobagyi GN, Kau S-WC, Theriault RL, Bondy ML: Breast cancer treatment guidelines in older women. J Clin Oncol. 2005, 23: 783-791. 10.1200/JCO.2005.04.175.CrossRefPubMed Giordano SH, Hortobagyi GN, Kau S-WC, Theriault RL, Bondy ML: Breast cancer treatment guidelines in older women. J Clin Oncol. 2005, 23: 783-791. 10.1200/JCO.2005.04.175.CrossRefPubMed
20.
go back to reference Faivre J, Lemmes VEPP, Quipourt V, Bouvier AM: Management and survival of colorectal cancer in the elderly in population based-studies. Eur J Cancer. 2007, 43: 2279-2284. 10.1016/j.ejca.2007.08.008.CrossRefPubMed Faivre J, Lemmes VEPP, Quipourt V, Bouvier AM: Management and survival of colorectal cancer in the elderly in population based-studies. Eur J Cancer. 2007, 43: 2279-2284. 10.1016/j.ejca.2007.08.008.CrossRefPubMed
21.
go back to reference International Union Against Cancer (UICC): TNM classification of malignant tumors. Edited by: Sobin LH, Wittekind C. 1997, John Wiley & Sons, Inc, New York, NY, 5 International Union Against Cancer (UICC): TNM classification of malignant tumors. Edited by: Sobin LH, Wittekind C. 1997, John Wiley & Sons, Inc, New York, NY, 5
22.
go back to reference Ederer F, Axtell LM, Cutler SJ: The relative survival rate: a statistical methodology. Natl Cancer Inst Monogr. 1961, 6: 101-121.PubMed Ederer F, Axtell LM, Cutler SJ: The relative survival rate: a statistical methodology. Natl Cancer Inst Monogr. 1961, 6: 101-121.PubMed
23.
go back to reference Dickman PW, Sloggett A, Hills M, Hakulinen T: Regression models for relative survival. Stat Med. 2004, 23: 51-64. 10.1002/sim.1597.CrossRefPubMed Dickman PW, Sloggett A, Hills M, Hakulinen T: Regression models for relative survival. Stat Med. 2004, 23: 51-64. 10.1002/sim.1597.CrossRefPubMed
24.
go back to reference Bastiaannet E, Portielje JEA, Van de Velde CJH, Craen AJM, Van der Velde S, Kuppen PJK, Van der Geest LGM, Janssen-Heijnen MLG, Dekkers OM, Westendorp RGJ, Liefers G-J: Lack of survival gain for elderly women with breast cancer. Oncologist. 2011, 16: 415-423. 10.1634/theoncologist.2010-0234.CrossRefPubMedPubMedCentral Bastiaannet E, Portielje JEA, Van de Velde CJH, Craen AJM, Van der Velde S, Kuppen PJK, Van der Geest LGM, Janssen-Heijnen MLG, Dekkers OM, Westendorp RGJ, Liefers G-J: Lack of survival gain for elderly women with breast cancer. Oncologist. 2011, 16: 415-423. 10.1634/theoncologist.2010-0234.CrossRefPubMedPubMedCentral
25.
go back to reference Land LH, Dalton SO, Jørgensen TL, Ewertz M: Comorbidity and survival after early breast cancer. A review. Crit Rev Oncol Hematol. 2011, 81: 196-205.CrossRefPubMed Land LH, Dalton SO, Jørgensen TL, Ewertz M: Comorbidity and survival after early breast cancer. A review. Crit Rev Oncol Hematol. 2011, 81: 196-205.CrossRefPubMed
26.
go back to reference Berrino F, De Angelis R, Sant M, Rosso S, Lasota MB, Coebergh JW, Santaquilani M, EUROCARE working group: Survival for eight major cancers and all cancers combined for European adults diagnosed in 1995-99: results of the EUROCARE-4 study. Lancet Oncol. 2007, 8: 773-783. 10.1016/S1470-2045(07)70245-0.CrossRefPubMed Berrino F, De Angelis R, Sant M, Rosso S, Lasota MB, Coebergh JW, Santaquilani M, EUROCARE working group: Survival for eight major cancers and all cancers combined for European adults diagnosed in 1995-99: results of the EUROCARE-4 study. Lancet Oncol. 2007, 8: 773-783. 10.1016/S1470-2045(07)70245-0.CrossRefPubMed
27.
go back to reference Weggelaar I, Aben KK, Warlé MC, Strobbe LJ, Van Spronsen DJ: Declined guideline adherence in older breast cancer patients: a population-based study in The Netherlands. Breast J. 2011, 17: 239-245. 10.1111/j.1524-4741.2011.01074.x.CrossRefPubMed Weggelaar I, Aben KK, Warlé MC, Strobbe LJ, Van Spronsen DJ: Declined guideline adherence in older breast cancer patients: a population-based study in The Netherlands. Breast J. 2011, 17: 239-245. 10.1111/j.1524-4741.2011.01074.x.CrossRefPubMed
28.
go back to reference Schonberg MA, Marcantonio ER, Li D, Silliman RA, Ngo L, McCarthy EP: Breast cancer among the oldest old: tumor characteristics, treatment choices, and survival. J Clin Oncol. 2010, 28: 2038-2045. 10.1200/JCO.2009.25.9796.CrossRefPubMedPubMedCentral Schonberg MA, Marcantonio ER, Li D, Silliman RA, Ngo L, McCarthy EP: Breast cancer among the oldest old: tumor characteristics, treatment choices, and survival. J Clin Oncol. 2010, 28: 2038-2045. 10.1200/JCO.2009.25.9796.CrossRefPubMedPubMedCentral
Metadata
Title
Population-based study of breast cancer in older women: prognostic factors of relative survival and predictors of treatment
Authors
Pegdwende Olivia Dialla
Tienhan Sandrine Dabakuyo
Sophie Marilier
Julie Gentil
Patrick Roignot
Ariane Darut-Jouve
Marie-Laure Poillot
Valérie Quipourt
Patrick Arveux
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2012
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/1471-2407-12-472

Other articles of this Issue 1/2012

BMC Cancer 1/2012 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