Do site and type of metastasis in breast cancer show a changing pattern with increased age? A cross comparison of clinicopathological characteristics between age groups

Majid Akrami,Abdolrasoul Talei,Afrooz Sepahdar,Vahid Zangouri,Peyman Arasteh,Azam Askari,Sedigheh Tahmasebi,Babak Pezeshki

doi:10.1186/s12957-018-1435-1

Majid Akrami, Abdolrasoul Talei + Show 6 more

Open Access

https://doi.org/10.1186/s12957-018-1435-1

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Abstract

BackgroundIn here, we evaluated pattern of metastasis and cross-compared clinicopathological features between different age groups with breast cancer (BC).MethodsThis study was conducted in the Shiraz Breast Cancer Registry (largest BC registry in Iran). Patients were classified as < 30 years old (group 1), 30–60 years old (group 2), and > 60 years old (group 3). The three age groups were compared regarding clinical and baseline characteristics.ResultsOverall, 564 individuals entered group 1, 4519 group 2, and 670 group 3.Group 1 had lower rates of tumor necrosis (p < 0.001), higher lymphatic or vascular invasion (p = 0.002), estrogen receptor-negative individuals, and HER2-positive individuals (p ≤ 0.001).Younger groups had more stage 3 BC (31.1, 25.6, and 19.7% for groups 1, 2, and 3, respectively) (p = 0.016), grade 3 BC (27.4, 20.6, and 16.5% for groups 1, 2, and 3, respectively) (p = 0.001), and grade 3 nucleus (43.1, 34.5, and 27.6% for groups 1, 2, and 3, respectively) (p < 0.001).Group 1 had higher rates of regional metastasis (4.7 vs. 1.5 and 2.1% for groups 2 and 3, respectively). Younger individuals had higher rates of brain metastasis (13.3, 5.4, and 1.1% for groups 1, 2, and 3, respectively). Moreover, those > 60 years old had more lung metastasis (33 vs. 12.6 and 6.7% for groups 2 and 1, respectively) (p < 0.001).Younger groups had more < 5-year recurrence (16.3, 11.7, and 8.9%, for groups 1, 2, and 3, respectively) (p = 0.023).ConclusionPattern and site of recurrence changes according to age in BC. This brings up the question whether age is an independent predictor of organ of metastasis or is site of metastasis the result of other clinicopathological determinants which differ between age groups.

Highlights

In here, we evaluated pattern of metastasis and cross-compared clinicopathological features between different age groups with breast cancer (BC)
Younger groups had more stage 3 BC (31.1, 25.6, and 19.7% for groups 1, 2, and 3, respectively) (p = 0.016), grade 3 BC (27.4, 20.6, and 16.5% for groups 1, 2, and 3, respectively) (p = 0.001), and grade 3 nucleus (43.1, 34.5, and 27.6% for groups 1, 2, and 3, respectively) (p < 0.001)
Comparison of baseline and clinical characteristics between age groups showed that the groups were significantly different regarding pathological sub-type, tumor necrosis, invasion status, ER receptor status, human epidermal receptor2 (HER2) expression status, BC stage, BC grade, grade of nucleus, operation type, site of metastasis, lymph node management, chemotherapy, radiotherapy, hormone therapy, and type of hormone therapy (p < 0.05)

Summary

Introduction

We evaluated pattern of metastasis and cross-compared clinicopathological features between different age groups with breast cancer (BC). BC in the elderly population is considered to have a better clinical presentation regarding receptor status [human epidermal receptor (HER2) expression], grade, lymph node involvement, and tumor size [4, 5]; some studies have shown that older individuals are diagnosed at later stages [6]. Different gene expression and BC characteristics have advocated researchers to consider the disease a separate entity among this population [9, 10]. Studies comparing the two populations have included limited data on patient- and disease-specific characteristics [5, 11, 12]. Considering that previous literature has shown BC to be different between young and older patients, in here, we hypothesized that pattern of metastasis and, more importantly, location of metastasis maybe different between these groups of patients

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Conclusion