Breast cancer in postmenopausal patients: Impact of age

• Published in: Journal of B.U. ON. Vol. 20; no. 3; p. 723
• Main Authors: Abu Rabi, Zaki, Zoranovic, Tamara, Milovanovic, Jelena, Todorovic-Rakovic, Natasa, Nikolic-Vukosavljevic, Dragica
• Format: Journal Article
• Language: English
• Published: Greece 01-05-2015
• Subjects: Age Factors; Aged; Aging; Biomarkers, Tumor - analysis; Breast Neoplasms - chemistry; Breast Neoplasms - mortality; Breast Neoplasms - pathology; Breast Neoplasms - therapy; Carcinoma, Ductal, Breast - chemistry; Carcinoma, Ductal, Breast - mortality; Carcinoma, Ductal, Breast - secondary; Carcinoma, Ductal, Breast - therapy; Chemotherapy, Adjuvant; Disease Progression; Disease-Free Survival; Estrogen Antagonists - therapeutic use; Female; Humans; Kaplan-Meier Estimate; Middle Aged; Neoplasm Recurrence, Local; Neoplasm Staging; Postmenopause; Receptors, Estrogen - analysis; Receptors, Estrogen - drug effects; Receptors, Progesterone - analysis; Retrospective Studies; Risk Factors; Tamoxifen - therapeutic use; Time Factors; Treatment Outcome
• ISSN: 1107-0625

We analyzed the significance of age together with other classic prognostic parameters on the course of breast cancer in postmenopausal patients.
Our study included 151 postmenopausal patients with primary breast cancer, of which 55% received adjuvant tamoxifen therapy and 45% did not receive any kind of therapy. Probabilities of disease-free interval (DFI) were estimated using the Kaplan-Meier method and were compared by the log-rank test. A p value<0.05 was considered as statistically significant.
In the tamoxifen-treated subgroup, patients with estrogen receptor (ER) or progesterone receptor (PR) concentration≥5 fmol/mg had favorable course of disease (p<0.01, p<0.04), respectively. Patients≥66 years of age had a worse disease course compared to those<66 years. Also, patients≥66 years with pT1 tumors had a worse disease course compared to those<66 years and pT1 tumors. This result was repeated in other groups as well. In pT2 (≥2 cm), ER-positive, PR-positive and invasive ductal carcinoma (IDC) subgroups, patients≥66 years always had a worse disease course compared to patients<66 years. In the untreated subgroup, patients with ER≥52 fmol/mg (p<0.01), tumors≥2 cm (p<0.01), IDC (p<0.01) type or ≥56 years (p<0.04) had statistically more recurrences. Among patients≥56 years, those with ER-positive or pT2 tumors had shorter DFI compared to ER-negative or pT1. Positive correlation between ER, PR and age of patients was also shown in this subgroup (p<0.03, p<0.02).
Age of patients, ER and PR are significant prognostic factors in the tamoxifen-treated subgroup. In the untreated subgroup relevant prognostic parameters are age, tumor size, histological type and ER. The above prognostic factors retained their value in the long-term follow up in both the investigated subgroups of patients.