J Breast Cancer.  2017 Dec;20(4):368-377. 10.4048/jbc.2017.20.4.368.

Treatment Patterns and Outcomes in Elderly Patients with Metastatic Breast Cancer: A Multicenter Retrospective Study

• Park JH
• Choi IS
• Kim KH
• Kim JS
• Lee KH
• Kim TY
• Im SA
• Kim SH
• Kim YJ
• Kim JH

• KMID: 2398207
• DOI: http://doi.org/10.4048/jbc.2017.20.4.368

Abstract

PURPOSE
Currently, there is little information regarding optimal treatment for metastatic breast cancer (MBC) in elderly patients. In this retrospective study, we examined a cohort of elderly patients with MBC receiving a range of treatments, in terms of demographic and clinicopathologic characteristics, treatment patterns, and outcomes.
METHODS
Patients aged 65 years and older, and diagnosed with MBC between 2003 and 2015, were identified from the databases of three academic hospitals in South Korea. A total of 161 cases were eligible for inclusion. We assessed clinicopathologic features, treatment patterns, and outcomes, using the available electronic medical records. Based on age at MBC diagnosis, patients were divided into three groups: 65 to 69, 70 to 74, and ≥75 years.
RESULTS
Most patients had received active treatment according to biologic subtype as in younger patients, although frequent dose modifications were observed during chemotherapy. The median overall survival (OS) for all patients was 30.3 months; age (≥70 years), Eastern Cooperative Oncology Group (ECOG) performance status (PS) (≥2), triple-negative cancer, and number of metastatic sites (≥2) were significant poor prognostic factors for OS in multivariate analyses. All types of systemic treatments according to biologic subtype conferred more prolonged OS in patients receiving treatment. Patients aged ≥75 years were more likely to have a poor ECOG PS and advanced comorbidity, and tended to receive less intensive treatments compared to the other age groups.
CONCLUSION
Elderly patients with MBC should not be excluded from receiving standard treatments prescribed for younger patients. Future research plans for elderly patients, especially aged ≥75 years with breast cancer, should include a geriatric assessment for identifying individuals at risk for treatment-related toxicity. Overall, this analysis will provide a better understanding of this population and help guide clinical care in real-world practice.

Keyword

Aged; Breast neoplasms; Drug therapy; Survival

MeSH Terms

Aged*
Breast Neoplasms*
Breast*
Cohort Studies
Comorbidity
Diagnosis
Drug Therapy
Electronic Health Records
Geriatric Assessment
Humans
Korea
Multivariate Analysis
Retrospective Studies*

Figure

• 

  Figure 1 The Kaplan-Meier survival curves for overall survival (OS). Survival curves for OS in all patients (n=161) (A). Survival curves for OS according to biologic subtype (B).HR=hormone receptor; HER2=human epidermal growth factor receptor 2; TNBC=triple-negative breast cancer.

• 

  Figure 2 The Kaplan-Meier survival curves for overall survival (OS) according to treatments. Survival curves for OS in patients who received at least one chemotherapy regimen compared to those who did not (A). Survival curves for OS in patients who received at least one hormonal therapy compared to those who did not (B). Survival curves for OS in patients who received at least one anti-HER2 therapy compared to those who did not (C).HT=hormonal therapy; HER2=human epidermal growth factor receptor 2.

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