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Screening-relevant age threshold of 70 years and older is a stronger determinant for the choice of adjuvant treatment in breast cancer patients than tumor biology.
Inwald, E C; Ortmann, O; Koller, M; Zeman, F; Hofstädter, F; Evert, M; Brockhoff, G; Klinkhammer-Schalke, M.
Afiliación
  • Inwald EC; Department of Gynecology and Obstetrics, University Medical Center Regensburg, Regensburg, Germany. elisabeth.inwald@klinik.uni-regensburg.de.
  • Ortmann O; Department of Gynecology and Obstetrics, University Medical Center Regensburg, Regensburg, Germany.
  • Koller M; Center for Clinical Studies, University Hospital Regensburg, Regensburg, Germany.
  • Zeman F; Center for Clinical Studies, University Hospital Regensburg, Regensburg, Germany.
  • Hofstädter F; Tumor Center Regensburg, University of Regensburg, Regensburg, Germany.
  • Evert M; Institute of Pathology, University of Regensburg, Regensburg, Germany.
  • Brockhoff G; Department of Gynecology and Obstetrics, University Medical Center Regensburg, Regensburg, Germany.
  • Klinkhammer-Schalke M; Tumor Center Regensburg, University of Regensburg, Regensburg, Germany.
Breast Cancer Res Treat ; 163(1): 119-130, 2017 May.
Article en En | MEDLINE | ID: mdl-28205042
PURPOSE: The 70-year threshold determines whether patients are eligible or not for the breast cancer screening program in Germany. It is not known whether this age threshold also influences the choice of adjuvant treatment and ultimate outcome. METHODS: 3463 patients were analyzed from the clinical cancer registry Regensburg (Germany) with primary, non-metastatic invasive breast cancer diagnosed between 2000 and 2012. The distribution of tumor biological subtypes was evaluated in breast cancer patients both in those eligible for screening (ESG, 50-69 years) and those not eligible for screening (NESG, ≥70 years). Local and systemic therapies in different subtypes as well as overall survival (OS) were analyzed. RESULTS: 2171 patients (62.7%) pertained to the ESG and 1292 patients (37.3%) referred to the NESG. The distribution of the common subtypes Luminal A, Luminal B, HER2-like, and Basal-like was comparable in both groups. Treatment varied considerably with less systemic therapies in all subtypes in patients in the NESG. Regarding local therapies, patients in the NESG also received less surgery and less radiotherapy. As to Luminal A patients, best OS was seen in patients receiving endocrine therapy (ET) (7-year OS of 95.6%) and CHT plus ET (7-year OS of 93.1%) in the ESG. In the NESG, best OS was seen in patients receiving CHT plus ET (7-year OS of 95.2%), whereas patients receiving only ET had a 7-year OS of 73.9%. CONCLUSIONS: Despite similar tumor biology, elderly patients are undertreated regarding both systemic and local therapies compared to younger patients, leading to reduced OS.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Mama / Receptor ErbB-2 Tipo de estudio: Diagnostic_studies / Prognostic_studies / Screening_studies Límite: Aged / Aged80 / Female / Humans / Middle aged País/Región como asunto: Europa Idioma: En Revista: Breast Cancer Res Treat Año: 2017 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Países Bajos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Mama / Receptor ErbB-2 Tipo de estudio: Diagnostic_studies / Prognostic_studies / Screening_studies Límite: Aged / Aged80 / Female / Humans / Middle aged País/Región como asunto: Europa Idioma: En Revista: Breast Cancer Res Treat Año: 2017 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Países Bajos