Among postmenopausal women with hormone receptor-positive breast cancer, increasing age was associated with a higher risk of death from breast cancer, according to a study.
Breast cancer is the leading contributor to cancer incidence and cancer mortality in women worldwide, with almost 1.4 million new cases in 2008, the authors wrote in background information for the study, which appeared in the Feb. 8 issue of JAMA. In the United States that year, 41% of newly diagnosed breast cancer patients were women ages 65 and older.
"Because breast cancer incidence increases with increasing age, changing demographics and continuously increasing life expectancy will further enlarge the number of older women confronted with breast cancer," the authors wrote. "In addition to classic tumor-related prognostic factors, patient characteristics may be associated with breast cancer outcome."
Willemien van de Water, MD, of the Leiden University Medical Center in the Netherlands, and colleagues conducted a study to assess disease-specific mortality among age groups in postmenopausal patients with hormone receptor-positive breast cancer. The study consisted of an analysis of 9,766 patients enrolled in the TEAM (Tamoxifen Exemestane Adjuvant Multinational) randomized clinical trial between January 2001 and January 2006. Age at diagnosis was categorized as younger than 65 (5,349 patients), 65 to 74 (3,060) and 75 or older (1,357).
During midpoint follow-up of approximately 5.1 years, there were a total of 1,043 deaths. Cumulative incidence of death due to breast cancer increased from 5.7% in patients younger than 65 to 6.3% in patients ages 65 to 74 and 8.3% in patients 75 and older.
Increasing age was associated with a lower number of deaths due to breast cancer as a proportion of all-cause mortality (younger than 65, 77.5%; 65 to 74, 56.3%; 75 and older, 36.3%). But additional analysis indicated that compared with patients younger than 65, disease-specific mortality increased with age for patients 65 to 74 and patients 75 and older.
The researchers also found increasing age was associated with a higher risk of breast cancer relapse.
The authors said a possible underlying mechanism that might help explain the age-specific outcome in this relatively healthy population is that older patients may experience under-treatment, in particular under-treatment of either chemotherapy or radiotherapy.
"Regardless of a higher risk of other-cause mortality and independent of tumor and treatment characteristics, disease-specific mortality increases with age among postmenopausal women with hormone receptor-positive breast cancer," the authors wrote. "These data underline the need for age-specific breast cancer studies to improve breast cancer outcomes in patients of all ages.
"Moreover, future detailed population-based and translational studies may increase insight into causal factors of higher disease-specific mortality and breast cancer relapse with increasing age."
To read a study summary and access the study via subscription or purchase, visit http://bit.ly/y92cQU.
Breast cancer is the leading contributor to cancer incidence and cancer mortality in women worldwide, with almost 1.4 million new cases in 2008, the authors wrote in background information for the study, which appeared in the Feb. 8 issue of JAMA. In the United States that year, 41% of newly diagnosed breast cancer patients were women ages 65 and older.
"Because breast cancer incidence increases with increasing age, changing demographics and continuously increasing life expectancy will further enlarge the number of older women confronted with breast cancer," the authors wrote. "In addition to classic tumor-related prognostic factors, patient characteristics may be associated with breast cancer outcome."
Willemien van de Water, MD, of the Leiden University Medical Center in the Netherlands, and colleagues conducted a study to assess disease-specific mortality among age groups in postmenopausal patients with hormone receptor-positive breast cancer. The study consisted of an analysis of 9,766 patients enrolled in the TEAM (Tamoxifen Exemestane Adjuvant Multinational) randomized clinical trial between January 2001 and January 2006. Age at diagnosis was categorized as younger than 65 (5,349 patients), 65 to 74 (3,060) and 75 or older (1,357).
During midpoint follow-up of approximately 5.1 years, there were a total of 1,043 deaths. Cumulative incidence of death due to breast cancer increased from 5.7% in patients younger than 65 to 6.3% in patients ages 65 to 74 and 8.3% in patients 75 and older.
Increasing age was associated with a lower number of deaths due to breast cancer as a proportion of all-cause mortality (younger than 65, 77.5%; 65 to 74, 56.3%; 75 and older, 36.3%). But additional analysis indicated that compared with patients younger than 65, disease-specific mortality increased with age for patients 65 to 74 and patients 75 and older.
The researchers also found increasing age was associated with a higher risk of breast cancer relapse.
The authors said a possible underlying mechanism that might help explain the age-specific outcome in this relatively healthy population is that older patients may experience under-treatment, in particular under-treatment of either chemotherapy or radiotherapy.
"Regardless of a higher risk of other-cause mortality and independent of tumor and treatment characteristics, disease-specific mortality increases with age among postmenopausal women with hormone receptor-positive breast cancer," the authors wrote. "These data underline the need for age-specific breast cancer studies to improve breast cancer outcomes in patients of all ages.
"Moreover, future detailed population-based and translational studies may increase insight into causal factors of higher disease-specific mortality and breast cancer relapse with increasing age."
To read a study summary and access the study via subscription or purchase, visit http://bit.ly/y92cQU.
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