Age and comorbidities affect prognosis and treatment options in breast cancer
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Last Modified: November 1, 2001
In a study by the National Institute on Aging (NIA) and the National Cancer Institute, Dr. Rosemary Yancik from the NIA in Bethesda, Maryland and colleagues performed a retrospective chart review of 1800 postmenopausal women with breast cancer, ages 55 and older. In total, 73% of the women had stage I or stage II breast cancer, 10% had stage III or stage IV disease, and 17% were not assigned a stage.
Nearly all patients with stage I or stage II node-negative breast cancer received treatment that was consistent with National Institutes of Health (NIH) recommendations. However, a significant inverse relationship was noted between patient age group and likelihood of receiving NIH-consistent therapy. In addition, on logistic regression analysis, women aged 70 years and older were significantly less likely to undergo axillary lymph node dissection.
The presence of diabetes, renal failure, stroke, liver disease, a previous malignant tumor, and smoking were statistically significant predictors of early mortality when age and disease were included. Just over half of all deaths were from breast cancer. Heart disease and previous cancers were the next most common causes. By the end of the 30-month followup period, 15% of subjects had died.
"This paper is really a surveillance report, documenting, with population-based data, the magnitude not only of the cancer burden but of the age-related burden of other issues," Dr. Yancik told Reuters Health. "Breast cancer rates peak in the upper age segment of the population," she said. "A lot of people don't really know that."
"The other important message is that breast cancer doesn't occur by itself," Dr. Yancik noted. "In older women, it is occurring in a woman's body that may have preexisting illnesses." However, Dr. Yancik went on to say that she believes "it is important to emphasize the heterogeneity of aging and of the tumor stage."
"As long as prevention and cure of breast cancer remain elusive, postmenopausal women will require additional health resources to promote early detection, optimum treatment, long-term followup, and supportive care," the researchers conclude in the journal.
- JAMA 2001;285:885-892. (Abstract not available online at time of posting.)