Age-Related Variation in the Treatment and Outcomes of patients with Breast Carcinoma

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

Introduction

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.

Method

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.

Results

• 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.

Discussion

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.