Limited Impact of Breast Cancer and Non-breast Malignancies on Survival in Older Patients with Early-Stage Breast Cancer: Results of a Large, Single-Centre, Population-Based Study

• Published in: Clinical oncology (Royal College of Radiologists (Great Britain)) Vol. 34; no. 6; pp. 355 - 362
• Main Authors: Jobsen, J.J., van der Palen, J., Siemerink, E., Struikmans, H.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-06-2022
• Subjects: Aged; Breast cancer; Breast Neoplasms - epidemiology; Breast Neoplasms - pathology; Breast Neoplasms - therapy; Female; Humans; Mastectomy, Segmental; Neoplasm Staging; older adults; population-based study; second malignancy; survival; Survival Analysis; Survival Rate; NBM; older adults; second malignancy; Breast cancer; population-based study; survival
• ISSN: 0936-6555; 1433-2981; 1433-2981
• DOI: 10.1016/j.clon.2021.11.005

To analyse the disease-free survival and overall survival in older adults with breast cancer after breast-conserving therapy, focusing on the relevance of non-breast malignancy (NBM) with respect to survival rates.
Analyses were based on 1205 women aged 65 years and older with breast cancer treated with breast-conserving therapy between 1999 and 2015. Patients were divided into three age categories: 65–70, 71–75 and >75 years. Multivariate survival analysis was carried out using Cox regression analysis.
The two youngest age categories showed excellent results, with a 12-year disease-free survival of 84.6 and 86.3%, respectively. We noted a 17.2% incidence of NBM, particularly for colon cancer and lung cancer. Most (72.9%) occurred after a diagnosis of breast cancer. Of those 72.9%, about 50% died as a result of NBM within 2 years of the diagnosis of NBM. The overall 12-year NBM-specific survival was 92.0%. The 12-year overall survival was 60.0% for all and for the three abovementioned age categories was 73.3, 54.4 and 28.4%, respectively. The cause of death for all was predominantly non-malignancy-related morbidity.
The impact of breast cancer on life expectancy was limited, in particularly for women aged 65–75 years. The relevance of NBM on survival was limited.
•A large population-based breast cancer cohort of older patients with long follow-up.•Impact on life expectancy of second non-breast malignancies in an older breast cancer population.•Low impact of breast cancer on life expectancy on older patients.•The causes of death were predominantly non-malignancy related.