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Age-Related Variation in the Treatment and Outcomes of patients with Breast Carcinoma
Jonathan Golledge, Joan E. Wiggins, Michael J. Callam
Abramson Cancer Center of the University of Pennsylvania
Ultima Vez Modificado: 1 de noviembre del 2001
Reviewers: Li Liu, MD
Source: Cancer, Volume 88:369-374, (January) 2000
Précis: Breast cancer diagnosed between ages 60 and 69 appeared to have more favorable outcome
The relationship between young age at diagnosis and the prognosis of early-stage breast cancer remains unresolved. Some investigators have reported young age to be associated with a poorer overall survival or cause-specific survival compared with older patients. Others have failed to show an association between young age and the risk of recurrence. (Arch Surg 1994 May; 129(5): 483-7
) This study assessed the outcomes for different age groups presenting with breast carcinoma in relation to stage and treatment.
A total of 784 patients who presented with breast cancer between 1990 and 1996 were included. Lymph node status and tumor grade were similar for all age groups.
- Older women were more likely to receive tamoxifen only.
- Younger women with node-negative cancer were nearly twice as likely as older women to experience locoregional relapse.
- Patients aged 60 to 69 had the best disease-free survival and local tumor control.
- Women 70 years or older experienced better 3-year disease-free survival when treated with standard therapy than when treated with tamoxifen alone.
In this study, women in their sixties who were diagnosed with breast cancer have a higher rate of disease-free survival and a lower rate of local recurrence than younger women. The reasons for the worse prognosis for young breast cancer patients remain unclear. The increased incidence of various poor-prognostic pathologic factors among young patients and their worse prognosis suggest that the disease may have a different biologic basis in at least a portion of young patients. Further research is necessary to establish the genetic alterations responsible for the disease and whether these are the same for young and older breast cancer patients.