Treatment Patterns and Outcomes in Elderly Patients with Metastatic Breast Cancer: A Multicenter Retrospective Study

Park, Jin Hyun; Choi, In Sil; Kim, Ki Hwan; Lee, Kyung-Hun; Kim, Tae-Yong; Im, Seock‐Ah; Kim, Se Hyun; Kim, Yu Jung; Kim, Jee Hyun

doi:10.4048/jbc.2017.20.4.368

Cited by 13 publications

(11 citation statements)

References 29 publications

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“…In addition, another study done in Japan comparing breast cancer patients in the 70s with those in the 80s and above revealed that the standard treatment was the main factor minimizing recurrence and distant metastasis [18]. Another study done in metastatic elderly patients showed that performance status and comorbidity were the main factors leading do under treatment in patients above 75 years [19].…”

Section: Discussionmentioning

confidence: 99%

Clinico-Epidemiological Study of Elderly Breast Cancer in a Developing Country: Egypt

Ibrahim¹

2019

JCTR

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Context: The prognosis and treatment outcome in elderly breast cancer is not well known. Aim: To study the prognosis and treatment outcome in elderly breast cancer. Methods and materials: This a retrospective study of breast cancer patients' ≥70years in the period from January 2005 until December 2010 in Egypt. Kaplan Meir overall survival (OS) analysis and disease-free survival (DFS) were done and they were correlated with different prognostic factors. Results: Among 186 old patients, 139 one were analyzed. The median age was 73.4 years at diagnosis with a mean of 75. Most patients (70.4%) were in the range of 70-74 from urban areas (89.2%) with performance status 1-2 (90.6%) and with ≤ 2 co-morbidity (67.6%). Stage III and IV presented 43.9%. Positive ER and PR was 83.4% and 75.5% respectively. Surgery was done in 77.7% of cases with 62.6% modified radical mastectomy and 15.1% conservative lumpectomy and axillary clearance. Treatment included mostly hormonal treatment (79.9%), radiotherapy (47.5%) and lastly chemotherapy (18.7%). The 5-year OS and DFS were 52% and 53.4% respectively. The median progression free survival (PFS) in metastatic patients was 4 months. The DFS was significantly affected by performance status (PS), tumor stage, and presence of metastasis. (P-value = 0.018, <0.001, 0.003 respectively). Conclusion: the 5-year OS was lower than the developed country. The majority of deaths (55.7%) were not related to breast cancer. Primary tumor stage and metastasis were significant prognostic factor for DFS.

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Section: Discussionmentioning

confidence: 99%

Clinico-Epidemiological Study of Elderly Breast Cancer in a Developing Country: Egypt

Ibrahim¹

2019

JCTR

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“…Although the 3rd ESO‐ESMO international consensus guidelines for advanced breast cancer states that age alone should not determine the intensity of treatment, oncologists tend to choose less intensive therapy due to advanced age even in highly functional elderly . In a recent retrospective study on treatment patterns in MBC, patients aged ≥ 75 years were treated less often with chemotherapy than their younger counterparts and with less lines of chemotherapy . Although chemotherapy may result in toxicity, its use also may benefit patients by relieving or delaying symptoms of disease and prolonging survival.…”

Section: Introductionmentioning

confidence: 94%

“…3 In a recent retrospective study on treatment patterns in MBC, patients aged ≥ 75 years were treated less often with chemotherapy than their younger counterparts and with less lines of chemotherapy. 4 Although chemotherapy may result in toxicity, its use also may benefit patients by relieving or delaying symptoms of disease and prolonging survival. Knowledge on the feasibility of palliative chemotherapy in this category of patients could prevent under treatment, but studies in elderly patients with MBC are rare and most are not randomized including only highly selected and relatively fit patients rarely age 75 or older.…”

Section: Introductionmentioning

confidence: 99%

Outcome and feasibility of palliative chemotherapy in very elderly patients with metastatic breast cancer

et al. 2020

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In the Netherlands, approximately 1300 women aged ≥75 years die every year of metastatic breast cancer (MBC). Data on palliative chemotherapy (CT) in very elderly patients are rare, and prospective studies appeared cumbersome. Therefore, we retrospectively analyzed the outcome and feasibility of chemotherapy in elderly MBC patients. Records of all patients with MBC aged ≥75 years who received first‐line palliative chemotherapy between January 2000 and December 2014 at two large teaching hospitals in the Netherlands were reviewed. We registered patient and tumor characteristics together with data on previous adjuvant treatment, palliative endocrine treatment, comorbidities, clinical benefit (defined as ≥6 months progression‐free survival), toxicity, and the reason for stopping chemotherapy. Patients with progressive disease (PD) or death within 30 days after starting CT were censored from analysis. A total of 54 patients with a median age of 77.6 years (range 75‐90) were treated with palliative chemotherapy for MBC. Of them, 20 patients (37%) were aged ≥ 80 years. There was clinical benefit in 28 patients (52%). Median progression‐free survival and median overall survival were 6.0 and 14.0 months, respectively. One year after the diagnosis of MBC, 27 patients (50%) were still alive and 15 patients (28%) lived longer than 2 years. Reasons for stopping CT were progressive disease (n = 32) or toxicity (n = 13). Most patients (n = 48) died of MBC while two patients died of toxicity. In selected patients with MBC aged 75 years or older, single‐agent palliative chemotherapy is feasible and may have clinical benefit.

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“…From 2010 to 2020, the prevalence of metastatic breast cancer (MBC) was estimated to rise by 31%(4), and accounting for 90% of breast cancer-related deaths (5,6). Metastasis is one of the independent risk factors for death from breast cancer (2,7).…”

Section: Introductionmentioning

confidence: 99%

Association of marital status and all-cause mortality of metastatic breast cancer patients: A population-based study

Zhu

Lei

2023

Preprint

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Background: Being married is positively associated with survival in patients with various types of malignancy. However, the significance of marital status on the prognosis of metastatic breast cancer (MBC) has not been explored. Methods: Data of MBC patients were extracted from the surveillance, epidemiology, and end results database from 2010 to 2015. Patients were separated into married and unmarried cohorts based on their marital status. The Kaplan–Meier analysis with log-rank test was performed to assess the difference in breast cancer-specific survival (BCSS) and overall survival (OS) between married and unmarried patients. Univariate and multivariate Cox proportional models were performed to assess whether marital status was independently associated OS. Fine-Gray subdistribution hazard method was performed to assess whether marital status was independently associated with BCSS. As potential confoundings, age, race, tumor pathologicalgrade, tumor subtype, chemotherapy, surgery, and metastasis pattern were adjusted in the multivariate model. Results: There were 16513 MBC patients identified, including 8949 married (54.19%) and 7564 unmarried patients (45.81%). When compared to the unmarried patients, married patients were younger (58.85±12.94 vs.63.41±14.75; p < 0.001), received more aggressive treatment, like chemotherapy (p < 0.001), and surgery (p< 0.001). Furthermore, the married population had higher 5‑year BCSS (42.64% vs. 33.17%, p < 0.0001) and OS (32.22% vs. 21.44%, p< 0.0001) rates. The multivariate analysis revealed that marital status was an independent prognostic factor, being married was associated with a significant reduction in the risk of breast cancer-specific (SHR: 0.845; 95% CI: 0.804–0.888; p < 0.001) and all-cause (HR: 0.810; 95% CI: 0.777–0.844; p < 0.001)mortality. In addition, BCSS as well as OS were superior in married populations than unmarried ones in most subgroups. Conclusion: Marital status was an independent prognostic indicator for survival in MBC patients. Married patients experience significant survival benefits in BCSS and OS.

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Treatment Patterns and Outcomes in Elderly Patients with Metastatic Breast Cancer: A Multicenter Retrospective Study

Cited by 13 publications

References 29 publications

Clinico-Epidemiological Study of Elderly Breast Cancer in a Developing Country: Egypt

Clinico-Epidemiological Study of Elderly Breast Cancer in a Developing Country: Egypt

Outcome and feasibility of palliative chemotherapy in very elderly patients with metastatic breast cancer

Association of marital status and all-cause mortality of metastatic breast cancer patients: A population-based study

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