TY - JOUR
T1 - Invasive Breast Cancer Treatment Patterns in Women Age 80 and Over
T2 - A Report from the National Cancer Database
AU - Frebault, Julia
AU - Bergom, Carmen
AU - Cortina, Chandler S.
AU - Shukla, Monica E.
AU - Zhang, Yiwen
AU - Huang, Chiang Ching
AU - Kong, Amanda L.
N1 - Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2022/1
Y1 - 2022/1
N2 - Background: There are no established treatment guidelines for women with breast cancer aged ≥80 despite increasing representation in the US population. Here we identify national treatment patterns and survival outcomes in women with stage I-III invasive breast cancer. Patients and Methods: Women age ≥80 diagnosed with stage I-III invasive breast cancer (IBC) were identified from 2005-2014 in the National Cancer Database. χ2, Fisher's exact test, and logistic regression models were used to identify factors influencing receipt of breast surgery, and Cox proportional hazard models were used to evaluate overall survival (OS). Results: A total of 62,575 women with IBC met inclusion criteria, of which the majority received surgery (94%). Receipt of surgery was associated with White race, age <90, lower stage, and fewer comorbidities. OS was higher for those who received surgery compared to those who did not (HR 3.3 [3.18-3.46] P < .001). Molecular subtype analysis demonstrated improved survival with receipt of surgery or radiation for all subtypes, as well as improved survival with chemotherapy for those with triple negative breast cancer. Conclusion: The vast majority of breast cancer patients aged ≥80 in the National Cancer Database with IBC received primary surgical management, which was associated with a significant OS benefit. Due to this finding, surgical resection should be considered for all patients ≥80 who are suitable operative candidates.
AB - Background: There are no established treatment guidelines for women with breast cancer aged ≥80 despite increasing representation in the US population. Here we identify national treatment patterns and survival outcomes in women with stage I-III invasive breast cancer. Patients and Methods: Women age ≥80 diagnosed with stage I-III invasive breast cancer (IBC) were identified from 2005-2014 in the National Cancer Database. χ2, Fisher's exact test, and logistic regression models were used to identify factors influencing receipt of breast surgery, and Cox proportional hazard models were used to evaluate overall survival (OS). Results: A total of 62,575 women with IBC met inclusion criteria, of which the majority received surgery (94%). Receipt of surgery was associated with White race, age <90, lower stage, and fewer comorbidities. OS was higher for those who received surgery compared to those who did not (HR 3.3 [3.18-3.46] P < .001). Molecular subtype analysis demonstrated improved survival with receipt of surgery or radiation for all subtypes, as well as improved survival with chemotherapy for those with triple negative breast cancer. Conclusion: The vast majority of breast cancer patients aged ≥80 in the National Cancer Database with IBC received primary surgical management, which was associated with a significant OS benefit. Due to this finding, surgical resection should be considered for all patients ≥80 who are suitable operative candidates.
KW - Breast surgery
KW - Geriatric oncology
KW - Invasive breast cancer
KW - Survival
KW - Treatment patterns
KW - Triple negative breast cancer
UR - http://www.scopus.com/inward/record.url?scp=85112506268&partnerID=8YFLogxK
U2 - 10.1016/j.clbc.2021.07.005
DO - 10.1016/j.clbc.2021.07.005
M3 - Article
C2 - 34391660
AN - SCOPUS:85112506268
SN - 1526-8209
VL - 22
SP - 49
EP - 59
JO - Clinical breast cancer
JF - Clinical breast cancer
IS - 1
ER -