Impact of modifiable risk factors on clinical outcomes in geriatric patients with breast cancer.

Abstract

e21546 Background: Tobacco use remains the single largest contributor to preventable death in the U.S. Women who consume alcohol have a 15% higher risk of hormone-receptor-positive breast cancer and obese women are at higher risk of developing breast cancer compared to non-obese women after menopause. There is limited information about the combined impact of smoking, alcohol and BMI on clinical outcomes among elderly patients . The purpose of this study was to analyze the effects of smoking, alcohol and BMI on clinical outcomes in geriatric breast cancer patients. Methods: Among 1659 patients in the institutional Breast Cancer Registry database, a total of 269 patients with histologically confirmed invasive or in-situ breast cancer with age 65 years or older at the time of diagnosis were reviewed in an IRB approved fashion. Clinical outcomes included assessment of the following risk factors: current/former smoking, current/former alcohol usage and BMI at time of diagnosis. Kaplan-Meyer and Cox proportional hazards methods were used to calculate clinical outcomes which included overall survival (OS) and disease free survival (DFS). Results: There were 110 (40.9%) never smokers, 41 (15.2%) current smokers and 80 (29.7%) former smokers. A total of 129 (48%) of women had never consumed alcohol, 73 (27.1%) currently consumed alcohol, and 19 (17.1%) previously consumed alcohol. Mean BMI at the time of diagnosis was 30.62. The OS and DFS was longer among patients who were never smokers compared to current and former smokers (P = 0.0125, P = .0.0077) (P = 0.0107, P = 0.0146). There was also no statistically significant decrease in OS, DFS among those who never consumed alcohol compared to current and former alcoholic users (P = 0.7516, P = 0.2027) (P = 0.8892, P = 0.2432). Neither was there a statistically significant decrease in OS, DFS based on BMI at time of diagnosis (P = 0.5045) (P = 0.5233). In patients with combined cigarette and alcohol usage with BMI > 25, there was also no statistically significant decrease in OS (P = 0.3572). Conclusions: In patients 65 years old or older diagnosed with breast cancer, prognosis for current or former smokers is worse compared to never smokers. Alcohol consumption and BMI have no impact on DFS or OS.