Abstract
BackgroundBreast cancer may differ biologically in patients aged over 80 years. The objective of the current study was to analyze the metastasis patterns and prognosis of elderly patients with metastatic breast cancer (MBC) and compare it to patients of other ages.MethodsThe Surveillance, Epidemiology, and End Results (SEER) database was utilized to select MBC patients from 2010 to 2015. Chi-squared test was used to compare clinicopathological characteristics among different aged groups. The Kaplan-Meier method and multivariate Cox model were utilized for survival analysis.ResultsA total of 10479 MBC patients were included, among which 1036 (9.9%) patients were aged over 80 years. Compared with other aged group, the elderly patients tended to have a higher proportion of HR+/Her2- subtype, white race, lower tumor differentiation, and receive less treatment, including surgery, chemotherapy and radiotherapy (P< 0.001). MBC patients with different age presented with distinctive metastatic patterns. The older patients were more likely to have lung metastasis, but less likely to have bone, brain, liver and multiple sites metastasis than the younger group (P <0.001). The proportion of TNBC subtype increased substantially in the older patients with brain metastasis, compared to the younger and middle-aged group. The old age was demonstrated to significantly associate with worse prognosis of MBC patients. Additionally, our findings also showed that older MBC patients could achieve dramatical overall survival benefit from surgery (HR = 0.58; P <0.001) and chemotherapy (HR = 0.59; P <0.001), but not the radiotherapy (HR = 0.96; P = 0.097).ConclusionThe elderly MBC patients presented with distinctive metastatic patterns, clinical characteristics, and prognostic outcomes compared with younger patients. Our findings could assist clinicians in making appropriate therapeutic decision.
Highlights
Breast cancer (BC) represents the most common malignancy in females, accounting for estimated 266120 new cases in the United States, in 2018 [1]
Our findings showed that older metastatic breast cancer (MBC) patients could achieve dramatical overall survival benefit from surgery (HR = 0.58; P
The elderly MBC patients presented with distinctive metastatic patterns, clinical characteristics, and prognostic outcomes compared with younger patients
Summary
Breast cancer (BC) represents the most common malignancy in females, accounting for estimated 266120 new cases in the United States, in 2018 [1]. 25% of breast cancer patients over age of 65 or 10.6% of all BC patients is reported to be 80 years-old or older [5]. Study showed that the incidence of breast cancer among the elderly group with 80–84 years-old (400 per 100,000 people) are much higher than that with 50–54 years-old (200 per 100,000 people) [6] These older patients ( 80 years-old) often receive inferior screening for breast cancer, and present as an challenge in their treatment [7]. Few previous reports have concentrated on analyzing the heterogeneity of metastatic pattern and prognosis among MBC patients older than 80 years. The objective of the current study was to analyze the metastasis patterns and prognosis of elderly patients with metastatic breast cancer (MBC) and compare it to patients of other ages
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