Abstract
There is still a paucity of data on how breast cancer (BC) biology influences outcomes in elderly patients. We evaluated whether ER/PR/HER2 subtype and TNM stage of invasive BC had a significant impact on overall survival (OS) in a cohort of 232 elderly Caucasian female patients (≥70 year old (y/o)) from our institution over a ten-year interval (January 1998–July 2008). Five ER/PR/HER2 BC subtypes classified per 2011 St. Gallen International Expert Consensus recommendations were further subclassified into three subtypes (traditionally considered “favorable” subtype-ER+/PR+/HER2−, and traditionally considered “unfavorable” BC subtypes: HER2+ and triple negative). OS was measured comparing these categories using Kaplan Meier curves and Cox regression analysis, when controlled for TNM stage. The majority of our patients (178/232 = 76.8%) were of the “favorable” BC subtype; 23.2% patients were with “unfavorable” subtype (HER2+ = 12% (28/232) and triple negative = 11.2% (26/232)). Although a trend for better OS was noted in HER2+ patients (68%) vs. 56% in ER+/PR+ HER2− or 58% in triple negative patients, “favorable” BC subtype was not significantly predictive of better OS (p = 0.285). TNM stage was predictive of OS (p < 0.001). These results are similar to our published studies on Caucasian BC patients of all ages in which ER/PR/HER2 status was not predictive of OS, irrespective of classification system used.
Highlights
The American Cancer Society estimates that 231,840 women will be diagnosed with breast carcinoma and 40,290 women will die from it in 2015 [1]
While the lifetime risk of developing breast carcinoma is still 1 in 8 women [2,3], the risk that a ě70 y/o woman will be diagnosed with breast cancer during the subsequent 10 years is much higher when compared to women ď70 y/o
We have previously shown in two of our institution’s studies that ER/PR/HER2 status was not predictive of overall survival of Caucasian female breast carcinoma patients, irrespective of the classification system used, while TNM stage was predictive of overall survival [9,10]
Summary
The American Cancer Society estimates that 231,840 women will be diagnosed with breast carcinoma and 40,290 women will die from it in 2015 [1]. While the lifetime risk of developing breast carcinoma is still 1 in 8 women (similar from 2003–2011) [2,3], the risk that a ě70 y/o woman will be diagnosed with breast cancer during the subsequent 10 years is much higher when compared to women ď70 y/o. Of new breast carcinoma cases being diagnosed in patients 70 years and older [3], there is still a paucity of data on how breast cancer biology influences outcomes in elderly patients.
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