Breast Cancer In Age Group Research Articles

Survival rates of patients with breast cancer in countries in the Eastern Mediterranean Region: a systematic review and meta-analysis.

Breast cancer is the fourth leading cause of death and disability in the Eastern Mediterranean Region (EMR); although the incidence is lower than in the developed regions, there has been an increasing trend in recent decades. Our aim was to calculate the pooled survival rate of patients with breast cancer in the EMR. We searched electronic databases from 1946 to 19 January 2018, without language restrictions. We used a random effect model to estimate pooled 1-, 3-, 5- and 10-year survival rates for patients with breast cancer. Chi-squared and I² index were used to assess between-study heterogeneity. Subgroup analysis and meta-regression were used to investigate the potential source of heterogeneity. We found 80 articles eligible for inclusion in our review. The pooled 1-, 3-, 5- and 10-year survival rates in women with breast cancer in the EMR were 0.95, 0.80, 0.71, and 0.56, respectively. The I² index indicated considerable between-study heterogeneity (all I² > 50%). The 5-year survival rate in the male subgroup was 0.63. The 5-year survival rate of women with breast cancer in age groups ≤ 39, 40-64, and 65+ years were 0.74, 0.76 and 0.58, respectively. There was a statistically significant association between the Human Development Index (β = 9, P = 0.01) and decade of study (β = 8.2, P = 0.04) and 5-year survival rate. The survival rate of women with breast cancer in those countries in the EMR which have better health care systems improved in the past decade; women aged 40-64 years had the best survival rate.

Female breast cancer in different age groups: clincopathological features and treatment strategies

Background: The proportion of breast cancer cases have been alarmingly increasing. In order to investigate the clinical and pathological features of breast cancer arising in all age groups and to provide evidence for therapy based on these features, we intended to conduct this study among three age groups, young (age ≤40), middle aged (>40-50) and elderly patients (>50). Methods: This cross-sectional study obtained data from the cancer center registry at King Fahad Medical City and included all women diagnosed as breast cancer between 1st January 2011 till 31st December 2012 and followed until December 2015 (n=155). Results: 25.2% patients were ≤40 years of age, 38.7% were >40-50 years and 36.1% were >50 years. The upper outer quadrant of the breast was most frequently area involved in all the three age groups. Majority of the cases were Invasive Ductal Carcinoma (IDC). 51.3% cases were of grade III in patients ≤40 years, 43.3% cases in the middle age group (>40-50 years) were of grade II and 44.6% patients were of grade III in the elderly group. More T3 tumours were noticed in the younger group and more T2 in the middle age group and greater lymph node involvement N2 in the age group >50 years. The mean survival time for patients' ≤40 was 37.6 months, 39.3 months for cases >40-50 years and 38.3 for patients >50 years old at the end of three years of follow up. At our cancer centre and among all the groups, majority of patients were treated with a combination of surgery, chemotherapy and radiationConclusions: This study identifies cliniopathological features of breast cancer in all age groups in a tertiary care center, Saudi Arabia. Distant metastasis was more prevalent among younger age group and the middle aged women had the best mean survival time after three years.

Abstract P3-02-09: Cost-effectiveness of screening with additional MRI for women with familial risk for breast cancer without a genetic predisposition

Abstract Background: To reduce mortality risk, women with a family history of breast cancer are often screened with mammography before 50 years of age. Additional Magnetic Resonance Imaging (MRI) can improve sensitivity. MRI screening is cost-effective for BRCA1/2 mutation carriers. However, for women with a family history of breast cancer without a proven mutation cost-effectiveness is not clear. We evaluated the cost-effectiveness of additional MRI for women with a familial risk in the largest prospective MRI screening study: the Dutch MRI Screening Study (MRISC). Materials & Methods: Between 1999 and 2007 a total of 1597 women (8370 women years at risk) between 25–70 years, with an estimated cumulative lifetime risk of 15–50% for breast cancer participated in the MRISC. Women were screened with clinical breast examination (CBE) every six months and annual mammography and MRI. We calculated the costs per detected breast cancer. In addition, MRISC data were incorporated into a micro simulation screening analysis model: MISCAN. This model simulates screening programs with different screening modalities and time intervals. Different screening schemes were evaluated and the cost per life-year gained (CLYG) estimated. Results: Forty-seven breast cancers, including 9 Ductal Carcinoma in Situ, were detected. Screening with additional MRI leads to a cost per detected breast cancer treated of €101,962. In increasing age-cohorts the cost decreased, probably due to the higher breast cancer incidence. The cost per detected and treated breast cancer in age group 40–50 years doubled in the age group >60 years. We will demonstrate these results more extensively. With MISCAN modeling we predicted that screening with this scheme from age 35 to 60 years reduces breast cancer mortality by 30% at a CLYG of €119,945 (3.5% discounting), compared to 21% estimated mortality reduction at €45,707 CLYG with mammography and CBE alone. Conclusion: Screening with MRI may improve survival for women with familial risk for breast cancer, but is expensive. However, it may be cost-effective for a select group. We will discuss subgroups that may benefit from MRI screening and in which age category MRI was most effective in our study. Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P3-02-09.

52P Breast Cancer Stem Cells: A Novel Therapy for Breast Cancer

ABSTRACT Simple BRCA screening is insufficient for ‘event-free survival’ as breast cancer is clinically and pathologically an extremely heterogeneous disease. Targeting breast cancer stem cells (BCSCs) present in bone marrow and breast tissues is an attractive alternative. Identification of BCSCs is the salient aspect of our research. The invasive and mesenchymal properties of BCSCs with CD44+/CD24low/ALDH1+ phenotype has made them a promising target for eliminating the metastatic capacity of primary tumors. We hypothesize that the ability to therapeutically attack stem cells hinges upon identifying unique targets such as cell surface markers which will be decisive for the development of specific target therapies. A total of 10 early chemo-naive patients with biopsy-proven triple-negative metastatic breast cancer in age group 18-36 years (mean age 28 years) were selected randomly and tested for CD44/CD24 cell surface markers following immunosorting using a magnetic cell sorter and immunophenotyping by flow cytometric analysis. Isolated BCSCs were cultured for in vitro drug sensitivity towards platinum, anthracycline and docetaxel and correlation was drawn between cell differentiation, percentage of stem cells and drug response. Accordingly chemotherapy was designed for a particular patient. The percentage of BCSCs in pre- and post-chemotherapeutic conditions were further compared. We have detected BCSCs in 90% of the cases. Among positive samples, 89% of patients showed platinum sensitivity and the rest were found to be anthracycline sensitive. No sensitivity to docetaxel was observed. In lieu of this, cisplatin was applied in vivo and the percentage of BCSCs came down to 6.58% from an initial 11.16% (for a representative case). Thus the primary aim to target BCSCs at onset of tumors in breast cancer patients to control metastasis and relapse of disease was somewhat obtained. We further plan to correlate the ratio of selected markers present in patients in pre- and post-chemotherapeutic condition with time to recurrence, mortality, morbidity and progression-free survival. Finally, if no BCSCs were to prevail after chemotherapy, then patients would be kept under observation and if traces were found, we would proceed to stem cell replacement. Disclosure All authors have declared no conflicts of interest.