Differences in clinicopathological characteristics, treatment, and survival outcomes between older and younger breast cancer patients

Abdel‐Razeq, Hikmat; Iweir, Sereen; Abdel-Razeq, Rashid; Rahman, Fadwa Abdel; Almasri, Hanan; Bater, Rayan; Taqash, Ayat; Abdelkhaleq, Hadeel

doi:10.1038/s41598-021-93676-w

Cited by 20 publications

(18 citation statements)

References 40 publications

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“…the mean age of diagnosis for breast cancer patients is 52.0 years old. Research has found when compared to the older patients, the younger patients present with several poor clinical indicators, including a stronger association with high-grade tumors, LVI, lymph-node involvement, more likely to be HER2-positive and triple-positive disease [ 37 ]. Our study also showed that less than 50 years old is an independent risk factor for ALNM (OR = 1.507).…”

Section: Discussionmentioning

confidence: 99%

Ultrasonography and clinicopathological features of breast cancer in predicting axillary lymph node metastases

Xiong

Zuo

et al. 2022

BMC Cancer

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Background Early identification of axillary lymph node metastasis (ALNM) in breast cancer (BC) is still a clinical difficulty. There is still no good method to replace sentinel lymph node biopsy (SLNB). The purpose of our study was to develop and validate a nomogram to predict the probability of ALNM preoperatively based on ultrasonography (US) and clinicopathological features of primary tumors. Methods From September 2019 to April 2022, the preoperative US) and clinicopathological data of 1076 T1-T2 BC patients underwent surgical treatment were collected. Patients were divided into a training set (875 patients from September 2019 to October 2021) and a validation set (201 patients from November 2021 to April 2022). Patients were divided into positive and negative axillary lymph node (ALN) group according pathology of axillary surgery. Compared the US and clinicopathological features between the two groups. The risk factors for ALNM were determined using multivariate logistic regression analysis, and a nomogram was constructed. AUC and calibration were used to assess its performance. Results By univariate and multivariate logistic regression analysis, age (p = 0.009), histologic grades (p = 0.000), molecular subtypes (p = 0.000), tumor location (p = 0.000), maximum diameter (p = 0.000), spiculated margin (p = 0.000) and distance from the skin (p = 0.000) were independent risk factors of ALNM. Then a nomogram was developed. The model was good discriminating with an AUC of 0.705 and 0.745 for the training and validation set, respectively. And the calibration curves demonstrated high agreement. However, in further predicting a heavy nodal disease burden (> 2 nodes), none of the variables were significant. Conclusion This nomogram based on the US and clinicopathological data can predict the presence of ALNM good in T1-T2 BC patients. But it cannot effectively predict a heavy nodal disease burden (> 2 nodes).

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Section: Discussionmentioning

confidence: 99%

Ultrasonography and clinicopathological features of breast cancer in predicting axillary lymph node metastases

Xiong

Zuo

et al. 2022

BMC Cancer

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“…In contrast, KI67 levels and adjuvant chemotherapy were signi cantly lower among the higher age quartile than among the lower quartile. One study showed that OS rates were not lower for young patients, despite their tumors and poorer prognosis, results that patients may have bene tted from more aggressive treatment [34,35]. Another study has shown that women over 65 years of age with T3N0M0 can bene t from radiotherapy in terms of OS and BCSS [36].…”

Section: Discussionmentioning

confidence: 99%

Age has a U-shaped Relationship with Breast Cancer Outcomes in Women

Xie

Wei

Huang

et al. 2022

Preprint

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Background and Objectives There is insufficient information available on how breast cancer prognosis is affected by age at diagnosis. Our study aimed to examine the association between age at diagnosis and overall survival (OS), breast cancer-specific survival (BCSS) and disease-free survival (DFS) rates. Methods 1054 breast cancer patients were obtained in our retrospective cohort study from March 7, 2013 to December 31, 2019. Patients were dividedinto four groups based on their age. Different age groups were described using the Kaplan-Meier method for OS, BCSS and DFS survival rates. A model of Cox proportional hazards ratio (HR) with restricted cubic splines (RCS) and smooth curve fitting were usedto estimate 95% confidence interval (CI) and hazard ratios (HRs) of OS, BCSS and DFS rates. Results 71 patients (6.74%) died and 144 patients (13.66%) recurred during a median follow-up of 4.86 years. Quarter 2 showed the best OS, BCSS, and DFS rates in the Kaplan-Meier survival analysis. The outcomes of RCS analysis indicated that there was a U-shaped relationship between the age and OS, BCSS and DFS rates despite after adjustment for other confounding factors, the inflection points of OS, BCSS and DFS rates were 44years, 37years and 41years. Conclusions In Asian women, there is a U-shaped association between age at diagnosis and breast cancer outcomes.

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“…Age is an important prognostic factor because many studies have shown differences in tumor characteristics between young breast cancer patients (< 40 years) and older breast cancer patients (≥40 years), that younger breast cancer patients have more aggressive clinicopathology characteristics and have a worse prognosis. The aggressive characteristics are positive axillary lymph node metastases, tumor size T-3/4, molecular subtype 18 positive HER-2/neu 8,11 and TNBC 9,11 histopathologic differentiation grade 3, lymphovascular invasion, higher stage 7,18 , p53 positive, MIB-1 positive, high mitotic index 10 . The same study showed that the aggressive characteristics of breast cancer patients at a young age were not different from those in old age, there was no difference in the stage and grade of differentiationalie 8,11 but very young patients (< 35 years) showed differences in disease stage 11,12 , tumor size 7 , lymph node metastases, HER-2/neu status 18 .…”

Section: Discussionmentioning

confidence: 99%

“…The aggressive characteristics are positive axillary lymph node metastases, tumor size T-3/4, molecular subtype 18 positive HER-2/neu 8,11 and TNBC 9,11 histopathologic differentiation grade 3, lymphovascular invasion, higher stage 7,18 , p53 positive, MIB-1 positive, high mitotic index 10 . The same study showed that the aggressive characteristics of breast cancer patients at a young age were not different from those in old age, there was no difference in the stage and grade of differentiationalie 8,11 but very young patients (< 35 years) showed differences in disease stage 11,12 , tumor size 7 , lymph node metastases, HER-2/neu status 18 . Other studies have shown that there are transitional genetic changes before the age of 40 years with low expression of the markers ER, PgR, luminal cytokeratosis, bcl2, and high expression of Ki67, HER2/neu and p53; as opposed to female patients over 70 years of age; while the age of 40-70 years is the transition of this genetic change 24 .…”

Section: Discussionmentioning

confidence: 99%

“…Relating to the age group, the clinicopathologic characteristics of patients <40 years old are different from those of older ages, but the differences are not consistent between one study and another [9][10][11][12][13][14] . Young breast cancer patients <40 years old must get attention with the recently high prevalence and incidence compared to the older patients 13,14,15 .…”

Section: Introductionmentioning

confidence: 99%

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The Association Between Age Groups with Clinicopathologic and Molecular Subtypes of Breast Cancer Patients

et al. 2022

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Introduction: The increase in incidence proportion of breast cancer disease among young patients < 40 years old is exceeding that of older patients. The purpose of the research is to know the differences between clinicopathologic and molecular subtypes between patients < 40 years old and ≥ 40 years old.Methods: The conducting research on Medical Records (MR) was an observational analytic method with a cross-sectional design. The independent variable was age. Dependent variables were histopathological type, stage of disease, grade of tumor, and molecular subtype of cancer. Univariate analyses to describe the samples. The differences between those variables according to age groups were analyzed by a bivariate statistic and the odds ratio with a confident interval (CI) of 95% of each variable would be displayed by binary logistic regression statistic. Results: The most prevalent age of breast cancer patients was in the range of 50-59 years (47%), the mean age of 53.66 ± 0.977 years, in the range of 29 years old to 86 years old, and patients aged < 40 years was 12%. Ductal carcinoma type (89.7%), stage III tumor (40.2%), poor differentiation grade III (60.7%), and luminal A subtype (42.7%) were the most prevalent clinicopathologic and molecular subtypes. There weren’t differences between histopathologic type, stage of disease, and molecular subtype with age. The histopathologic grade was different from the age variable (p=0.015). Old age had worse histopathologic differentiation than young age (OR 2.166; 95% CI 0.973-4.823).Conclusions: There weren’t significant differences between stage and molecular subtypes of breast cancer between age groups. There was poorer histopathologic differentiation in patients ≥ 40 years.

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Differences in clinicopathological characteristics, treatment, and survival outcomes between older and younger breast cancer patients

Cited by 20 publications

References 40 publications

Ultrasonography and clinicopathological features of breast cancer in predicting axillary lymph node metastases

Ultrasonography and clinicopathological features of breast cancer in predicting axillary lymph node metastases

Age has a U-shaped Relationship with Breast Cancer Outcomes in Women

The Association Between Age Groups with Clinicopathologic and Molecular Subtypes of Breast Cancer Patients

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