UZH-Logo

Maintenance Infos

Treatment of breast cancer in the elderly: A prospective, population-based Swiss study


Joerger, M; Thürlimann, B; Savidan, A; Frick, H; Rageth, C; Lütolf, U; Vlastos, G; Bouchardy, C; Konzelmann, I; Bordoni, A; Probst-Hensch, N; Jundt, G; Ess, S (2013). Treatment of breast cancer in the elderly: A prospective, population-based Swiss study. Journal of Geriatric Oncology, 4(1):39-47.

Abstract

Objectives
The primary objective of this population-based study is to describe the patterns of care of elderly patients with breast cancer (BC), and evaluate potential causative factors for the decrease in BC-specific survival (BCSS) in the elderly.
Patients and Methods
We included all or representative samples of patients with newly diagnosed BC from seven Swiss cancer registries between 2003 and 2005 (n = 4820). Surgical and non-surgical BC treatment was analyzed over 5 age groups (< 65, 65 to < 70, 70 to < 75, 75 to < 80 and ≥ 80 years), and the predictive impact of patient age on specific treatments was calculated using multivariate logistic regression analysis.
Results
The proportion of locally advanced, metastatic and incompletely staged BC increased with age. The odds ratio for performing breast-conserving surgery (BCS) in stages I–II BC (0.37), sentinel lymph node dissection (SLND) in patients with no palpable adenopathy (0.58), post-BCS radiotherapy (0.04) and adjuvant endocrine treatment (0.23) were all in disfavor of patients ≥ 80 years of age compared to their younger peers. Only 36% of patients ≥ 80 years of age with no palpable adenopathy underwent SLND. In the adjusted model, higher age was a significant risk factor for omitting post-BCS radiotherapy, SLND and adjuvant endocrine treatment.
Conclusions
This study found an increase in incomplete diagnostic assessment, and a substantial underuse of BCS, post-BCS radiotherapy, SLND and adjuvant endocrine treatment in elderly patients with BC. There is a need for improved management of early BC in the elderly even in a system with universal access to health care services.

Abstract

Objectives
The primary objective of this population-based study is to describe the patterns of care of elderly patients with breast cancer (BC), and evaluate potential causative factors for the decrease in BC-specific survival (BCSS) in the elderly.
Patients and Methods
We included all or representative samples of patients with newly diagnosed BC from seven Swiss cancer registries between 2003 and 2005 (n = 4820). Surgical and non-surgical BC treatment was analyzed over 5 age groups (< 65, 65 to < 70, 70 to < 75, 75 to < 80 and ≥ 80 years), and the predictive impact of patient age on specific treatments was calculated using multivariate logistic regression analysis.
Results
The proportion of locally advanced, metastatic and incompletely staged BC increased with age. The odds ratio for performing breast-conserving surgery (BCS) in stages I–II BC (0.37), sentinel lymph node dissection (SLND) in patients with no palpable adenopathy (0.58), post-BCS radiotherapy (0.04) and adjuvant endocrine treatment (0.23) were all in disfavor of patients ≥ 80 years of age compared to their younger peers. Only 36% of patients ≥ 80 years of age with no palpable adenopathy underwent SLND. In the adjusted model, higher age was a significant risk factor for omitting post-BCS radiotherapy, SLND and adjuvant endocrine treatment.
Conclusions
This study found an increase in incomplete diagnostic assessment, and a substantial underuse of BCS, post-BCS radiotherapy, SLND and adjuvant endocrine treatment in elderly patients with BC. There is a need for improved management of early BC in the elderly even in a system with universal access to health care services.

Citations

10 citations in Web of Science®
9 citations in Scopus®
Google Scholar™

Altmetrics

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Epidemiology, Biostatistics and Prevention Institute (EBPI)
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2013
Deposited On:18 Dec 2012 16:11
Last Modified:05 Apr 2016 16:14
Publisher:Elsevier
ISSN:1879-4068
Publisher DOI:https://doi.org/10.1016/j.jgo.2012.08.002
Official URL:http://www.sciencedirect.com/science/article/pii/S187940681200077X

Download

Full text not available from this repository.
View at publisher

TrendTerms

TrendTerms displays relevant terms of the abstract of this publication and related documents on a map. The terms and their relations were extracted from ZORA using word statistics. Their timelines are taken from ZORA as well. The bubble size of a term is proportional to the number of documents where the term occurs. Red, orange, yellow and green colors are used for terms that occur in the current document; red indicates high interlinkedness of a term with other terms, orange, yellow and green decreasing interlinkedness. Blue is used for terms that have a relation with the terms in this document, but occur in other documents.
You can navigate and zoom the map. Mouse-hovering a term displays its timeline, clicking it yields the associated documents.

Author Collaborations