Relative Survival of Older Patients with Indolent Lymphoma–Analysis From the SEER Database

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 5214-5214
Author(s):  
Mamatha Prabhakar ◽  
Bindu Kanapuru ◽  
Ahmedin Jemal ◽  
Charles Hesdorffer ◽  
William Ershler ◽  
...  
Keyword(s):  
Older Patients ◽  
Conflicts Of Interest ◽  
Oldest Old ◽  
Survival Rates ◽  
Age Groups ◽  
Indolent Lymphoma ◽  
Men And Women ◽  
Indolent Lymphomas ◽  
Hodgkin's Lymphomas ◽  
The Impact

Abstract Abstract 5214 Background: Indolent lymphomas account for 35–40% of Non-Hodgkin's lymphomas (NHL). The treatment choices, and as a result, the overall outcome of these indolent lymphomas seem to be changing with the introduction of chemoimmunotherapy. However, the impact of these new treatment approaches on the survival in older patients has not been specifically studied. Methods: We used data from the Surveillance, Epidemiology and End Results database to determine survival for older patients diagnosed with indolent lymphomas. We compared trends in survival between 1977–86, 1987–96 and 1997–2006 in men and women, for three age groups 65–74, 75–84 and 85+ years. Survival rates were calculated up to 9 years post-diagnosis. Results: Between 1977 and 2006, survival rates increased for both men and women in all three age groups. The greatest improvement in survival was seen at 5 years. Between 1977–86 and 1997–2006, 5-year survival rates increased in men/women by 21%/22%, 23%/29% and 16%/24% in the 65–74, 75–84 and 85+ age groups respectively. Survival gains increased with each decade in all age groups for both sexes with the most marked improvements between 1987–1996 & 1997–2006. Women in the first two groups consistently demonstrated a better survival than men. The oldest old men (85+) had the lowest survival rate with the majority of the deaths occurring in the first year of diagnosis. Conclusions: Survival for older patients has increased considerably in the interval between 1977–2006 with the largest improvement seen in the 75–84 year old age group. Larger increases in the survival rates between 1987–1996 and 1997–2006 might be accounted for by the benefits of immunotherapy with the introduction of rituximab in 1998. The increased early deaths noted in men 85+, could be related to treatment toxicity. While earlier treatment is being advocated for patients diagnosed with indolent lymphoma, the data we present imply that more careful consideration should be given to the selection of patients above the age of 85 for such treatment. Male-female differences in survival are interesting and further study would seem important to elucidate the causes. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Impact of tumor Epstein-Barr virus status on presenting features and outcome in age-defined subgroups of patients with classic Hodgkin lymphoma: a population-based study

Blood ◽  
2005 ◽  
Vol 106 (7) ◽  
pp. 2444-2451 ◽  
Author(s):  
Ruth F. Jarrett ◽  
Gail L. Stark ◽  
Jo White ◽  
Brian Angus ◽  
Freda E. Alexander ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Older Patients ◽  
Epstein Barr Virus ◽  
Statistical Significance ◽  
Survival Rates ◽  
Population Based ◽  
Population Based Study ◽  
Barr Virus ◽  
Epstein Barr ◽  
The Impact

AbstractThe association between tumor Epstein-Barr virus (EBV) status and clinical outcome in Hodgkin lymphoma (HL) is controversial. This population-based study assessed the impact of EBV status on survival in age-stratified cohorts of adults with classic HL (cHL). Data from 437 cases were analyzed with a median follow-up of 93 months. Overall survival (OS) was significantly better for EBV-negative compared with EBV-positive patients (P < .001), with 5-year survival rates of 81% and 66%, respectively; disease-specific survival (DSS) was also greater for EBV-negative patients (P = .03). The impact of EBV status varied with age at diagnosis. In patients aged 16 to 34 years, EBV-associated cases had a survival advantage compared with EBV-negative cases, but differences were not statistically significant (P = .21). Among patients 50 years or older, EBV positivity was associated with a significantly poorer outcome (P = .003). Excess deaths occurred in EBV-positive patients with both early- and advanced-stage disease. In multivariate analysis of OS in the older patients, EBV status retained statistical significance after adjusting for the effects of sex, stage, and B symptoms (P = .01). Impaired immune status may contribute to the development of EBV-positive cHL in older patients, and strategies aimed at boosting the immune response should be investigated in the treatment of these patients. (Blood. 2005;106:2444-2451)

The impact of a time target on older patients attending the emergency department

2010 ◽  
Vol 27 (Suppl 1) ◽  
pp. A2.1-A2
Author(s):  
Sue Mason
Keyword(s):  
Emergency Department ◽  
Older Patients ◽  
Age Groups ◽  
Unintended Consequences ◽  
Older Patient ◽  
Younger Patients ◽  
Patient Level ◽  
Level Data ◽  
Younger Age ◽  
The Impact

IntroductionThe 4 h emergency standard for English acute trusts was introduced in 2003 and became full established by 2008 at 98% for all Emergency Department (ED) patients to be seen and discharged. This study examined the impact of the target for older patients attending departments.MethodsRoutine patient level data was received from 15 English EDs representing 774 095 individual patient attendances during May and June for 2003 to 2006. The data were used to determine the distribution of the total time spent in the EDs. Attendances were compared for older patients (65 years and above) with younger age groups.ResultsA total of 145 596 attendances were for patients aged 65+ years (18.9%). Across each year analysed, these older patients have a significantly longer median total time in the ED than those younger than 65 years (162 min vs 103 min, p<0.001). In addition, older patients are significantly more likely to leave the emergency department in the last 20 min prior to 4 h (12.4% vs 5.2% in those <65 years, p<0.001). This proportion is growing year on year in both the admitted and discharged categories of patients. Finally, older patients are significantly more likely to breach the 4-h than their younger counterparts (16.6% vs 6.3%, p<0.001).ConclusionsThere are some unintended consequences of introducing the 4 h target in UK emergency departments. While the target has reduced overall time in departments, the older patient appears to be disadvantaged relative to younger patients. Older patients are more likely to be ‘rushed through’ to other unmonitored areas of the hospital just prior to the target or to breach the target altogether. This finding calls in to question the benefits that the target is conveying for individual patients, and especially the most vulnerable in society.

Statins Use Improves the Clinical Outcomes of Salvage Therapy in Relapsed/Refractory CLL

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 3931-3931
Author(s):  
Long Xuan Trinh ◽  
Young Kwang Chae ◽  
Preetesh Jain ◽  
Ohad Benjamini ◽  
Xuemei Wang ◽  
...  
Keyword(s):  
Overall Survival ◽  
Elderly Patients ◽  
Clinical Outcomes ◽  
Salvage Therapy ◽  
Older Patients ◽  
Conflicts Of Interest ◽  
Young Patients ◽  
The Other ◽  
Concurrent Use ◽  
The Impact

Abstract Abstract 3931 Introduction - Statins are a class of drugs used to lower cholesterol levels by inhibiting the enzyme HMG-CoA reductase. In addition, statins possess anti-inflammatory, immunomodulatory, antioxidant, and cell growth inhibitory properties. In B- CLL cells, statins induce in-vitro apoptosis (Daphne Chapman-Shimshon et-al), suggesting that statins might possess properties. We noticed a high prevalence of dyslipidemia in patients with chronic lymphocytic leukemia (CLL). However the impact of dyslipidemia and its modulation by statins on clinical outcomes of patients with CLL remains unclear. Therefore, we conducted a retrospective analysis to assess the effect of statins in patients with CLL who received salvage (fludarabine, cyclophosphamide and rituximab) FCR chemotherapy. Methods - We analyzed the clinical outcome of relapsed/refractory patients with CLL (n=284) who underwent FCR salvage therapy at our institution between 1999 and 2012. Patients who were uninterruptedly treated with statins at least one month prior to and during salvage therapy (n=35) were assigned to the statins arm, whereas the other arm consisted of 249 patients who were not treated with statins. The Cox proportional hazards regression model was used to assess the association between patient characteristics and progression-free survival (PFS) and overall survival (OS). Actual survival and PFS were estimated using the method of Kaplan-Meier, and OS and PFS were compared among two groups of patients using log-rank test. Results - All pretreatment characteristics of the patients with concurrent use of statins were similar to those who were not treated with statins except for their age. Patients in the statins arm were older: 21 patients (60%) were older than 65 compared to 74 patients of 249 (30%) in the other group (p<0.05). The median OS and PFS of all 284 patients were 3.9 years (95% CI: 3.4–4.5) and 1.74 years (95% CI: 1.6–2.3), respectively. PFS was significantly longer in patients treated with statins. Fifteen of the 35 statin-treated patients (43%) as opposed to only 36 of 249 (14%) in the non-statins group experience no disease progression. Concurrent use of statins significantly prolonged PFS. The median PFS for statin-treated v/s. untreated was 4.6 and 1.7 years, respectively (p<0.05). This significantly improved PFS was consistent in young and elderly patients. In young patients (age < 65) with statins, the median PFS was not reached whereas in patients who were not treated with statins it was 2 years (p<0.05). In older patients (age ≥ 65), PFS was significant longer with concurrent use of statins than without statins; estimated PFS were 2 and 1.6 years, respectively (p<0.05). With the median follow-up of 5 years, the median overall survival was significantly longer in patients treated with statins, with 17 of 35 (49%) patients of the statins group and 59 (24%) of 249 in patients who were not treated with statins alive at the end of study. Concurrent use of statins significantly prolonged OS with an estimated median OS for the two groups of 6.9 years and 3.9 years, respectively (p<0.05). This significantly improved OS was consistent in young and elderly patients. Young patients (age <65) with statins had a significant prolonged survival with an estimated OS of 8.6 years whereas estimated OS in young patients without statins (p<0.05) was only 4 years. In older patients (age ≥65) the median OS was significantly longer with the concurrent use of statins than without statins; estimated OS in the two subgroups were 6.9 and 2.6 years respectively, (p<0.05). Conclusions - In conclusion, concurrent use of statins significantly improved OS, PFS in relapsed/refractory CLL patients treated with salvage FCR therapy. Further studies to determine the role of statins and mechanism of action in patients with CLL are warranted. Disclosures: No relevant conflicts of interest to declare.

Impact Of Age On Toxicity Associated With Chemotherapy For Acute Lymphoblastic Leukaemia (ALL): Results From The UK Prospective Study UKALL2003

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 840-840
Author(s):  
Rachael E. Hough ◽  
Clare Rowntree ◽  
Rachel Wade ◽  
Nicholas Goulden ◽  
Chris Mitchell ◽  
...  
Keyword(s):  
Conflicts Of Interest ◽  
Residual Disease ◽  
Age Groups ◽  
Serious Adverse Events ◽  
Number Of Patients ◽  
Teenagers And Young Adults ◽  
The Uk ◽  
Cure Rates ◽  
The Impact

Abstract Despite the substantial improvements made in the outcomes of paediatric ALL, with ‘cure' rates now in excess of 90%, survival in teenage and young adult (TYA) patients has remained inferior. The reasons for this are likely multifactorial, including tumour biology, toxicity, compliance, access to clinical trials and protocol (adult or paediatric) used. We report the toxicity profiles observed in children, teenagers and young adults treated on the UK intensive, minimal residual disease (MRD) directed ALL protocol, UKALL2003. Of a total of 3126 patients treated, 1520 patients were under 5 years old, 767 were aged 5-9 years, 610 aged 10-15 years and 229 aged 16-24 years, with a median overall follow-up of 4 year and 10 months. The risk of serious adverse events (SAEs) was higher in patients older than 10 years (56% in 10-15 year olds, 53% in 16-24 year olds) compared to those aged 9 or younger (30% in under 5 years and 31% in 5-9 years)(p<0.0001), with no difference in the those aged 16-24 compared to younger teenagers (p=0.5). The incidence (per number of patients in each group) and distribution of toxicities according to age group is summarised in the table.Table 1Age in years<55-910-1516-24AllTotal number of patients1520767610229 NB: 56 pts≥20 years3126Infection n (%)328 (21.6%)130 (17.0%)145 (23.8%)72 (31.4%)675 (21.6%)Asaparaginase n (%)57 (3.8%)57 (7.4%)64 (10.5%)31 (13.5%)209 (6.7%)Methotrexate n (%)100 (6.6%)74 (9.6%)123 (20.2%)33 (14.4%)330 (10.6%)Steroid n (%)54 (3.6%)37 (4.8%)141 (23.1%)52 (22.7%)284 (9.0%)Vincristine n (%)34 (2.2%)11 (1.4%)22 (3.6%)7 (3.0%)74 (2.4%)Other SAEs94 (6.2%)42 (5.5%)90 (14.8%)25 (10.9%)251 (8.0%) The incidence of certain toxicities including viral infection (5.3%), asparaginase hypersensitivity (1.9%) and vincristine neurotoxicity (2.1%) appeared equivalent across all age groups. Avacular necrosis was seen predominantly in adolescents (83% of 147 events in 10-19 year olds) and was rare in those younger than 10 years (n=18) or older than 20 years (n=7). Asparaginase thrombotic events increased in frequency with increasing age (1.5% in under 5 years, 3.3% in 5-9 years, 4.4% in 10-15 years and 8.3% in 16-24 year olds)(p<0.0001). All other toxicities were more frequently observed in over 10 year olds compared to patients aged 9 or younger, with no difference between 16-24 year olds and 10-15 year olds. The impact of age on SAEs associated with intensive ALL chemotherapy varies according to specific toxicities. In general, toxicity is higher in those over 10 years compared to younger patients, with no excess toxicity in those aged 16-24 compared to 10-15 years. However, specific toxicities may increase with increasing age (thrombosis), be restricted to adolescence (AVN) or be unrelated to age (vincristine neurotoxicity, asparaginase hypersensitivity). Disclosures: No relevant conflicts of interest to declare.

Governance and long-term operating performance of family and non-family firms in Australia

2015 ◽  
Vol 32 (4) ◽  
pp. 398-421 ◽  
Author(s):  
Enver Halili ◽  
Ali Salman Saleh ◽  
Rami Zeitun
Keyword(s):  
Agency Costs ◽  
Family Firms ◽  
Conflicts Of Interest ◽  
Operating Performance ◽  
Survival Rates ◽  
Listed Companies ◽  
Family Ownership ◽  
Content Type ◽  
The Impact

Purpose – The purpose of this study is to conduct a comparative analysis of the long-term operating performance of family and non-family firms from the agency theoretic perspective. The analysis is focused on investigating the impact of family ownership on principal–agent conflicts of interest. Design/methodology/approach – This paper examines the relationship between firm operating performance and family ownership for a large sample of 677 Australian-listed companies. The paper uses the Generalised Method of Moments (GMM) estimator model developed by Arellano and Bond (1991) and used by other studies in finance (Baltagi, 2012; Bond, 2002; Mohamed et al., 2008). Findings – The empirical results show that firms with ownership concentration has a better operating performance due to the alignment of owner-management interests. This study also finds that family-listed companies have higher survival rates and perform better than non-family companies. Findings support the hypothesis that agency costs arise as a result of privileged access of information and self-interest behaviour of managers (outsiders) in firms with dispersed ownership structures. Originality/value – Earlier studies have only focused on short-term perspectives, particularly investigating small and medium types of Australian family businesses from narrow aspects, such as productivity, business behaviour, capital structure and leverage. Therefore, this paper has conducted a comparative examination of family and non-family firms listed on the Australian Stock Exchange (ASX) to identify the impact of agency costs on their financial performance.

scholarly journals Monitoring life expectancy levels during the COVID-19 pandemic: Example of the unequal impact of the first wave on Spanish regions

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241952 ◽  
Author(s):  
Sergi Trias-Llimós ◽  
Tim Riffe ◽  
Usama Bilal
Keyword(s):  
Life Expectancy ◽  
Count Data ◽  
Age Groups ◽  
Balearic Islands ◽  
Calendar Period ◽  
Men And Women ◽  
National Statistics ◽  
Spanish Regions ◽  
The Impact ◽  
Death Count

Background To provide an interpretable summary of the impact on mortality of the COVID-19 pandemic we estimate weekly and annual life expectancies at birth in Spain and its regions. Methods We used daily death count data from the Spanish Daily Mortality Monitoring System (MoMo), and death counts from 2018, and population on July 1st, 2019 by region (CCAA), age groups, and sex from the Spanish National Statistics Institute. We estimated weekly and annual (2019 and 2020*, the shifted annual calendar period up to 5 July 2020) life expectancies at birth as well as their differences with respect to 2019. Results Weekly life expectancies at birth in Spain were lower in weeks 11–20, 2020 compared to the same weeks in 2019. This drop in weekly life expectancy was especially strong in weeks 13 and 14 (March 23rd to April 5th), with national declines ranging between 6.1 and 7.6 years and maximum regional weekly declines of up to 15 years in Madrid. Annual life expectancy differences between 2019 and 2020 also reflected an overall drop in annual life expectancy of 0.9 years for both men and women. These drops ranged between 0 years in several regions (e.g. Canary and Balearic Islands) to 2.8 years among men in Madrid. Conclusions Life expectancy is an easy to interpret measure for understanding the heterogeneity of mortality patterns across Spanish regions. Weekly and annual life expectancy are sensitive and useful indicators for understanding disparities and communicating the gravity of the situation because differences are expressed in intuitive year units.

The Impact of Race, Age, and Sex in Follicular Lymphoma (FL): A Comprehensive SEER Analysis in the Pre- and Post-Rituximab Eras

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 1576-1576
Author(s):  
Chadi Nabhan ◽  
Briseis Aschebrook-Kilfoy ◽  
Brian C-H Chiu ◽  
Kimberly Kruczek ◽  
Anand Patel ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Racial Disparity ◽  
Conflicts Of Interest ◽  
Age Groups ◽  
Population Based ◽  
Low Ses ◽  
Asian Pacific Islander ◽  
Asian Pacific ◽  
The Impact ◽  
Persistent Inequality

Abstract Abstract 1576 Background: While racial disparity has been documented in a number of cancers, the impact of race, sex, and socioeconomic status (SES) on FL outcomes is not well defined. Furthermore, the impact of modern therapeutics on these disparities has not been fully explored. Methods: We examined population-based FL overall survival (OS) data from SEER 13 (1993–2008) for race, sex, age, and socioeconomic status (SES) over two consecutive 8-year periods: Era 1 (1993–2000, n=7,409) and Era 2 (2001–2008, n=9,083). Results: We identified a total 16,492 FL patients (pts) (white (W): n=13,441 (81.5%); Hispanic (H): n=1,417 (8.5%); Asian/Pacific Islander (A/PI): n=887 (5.3%); and Black (B): n=747 (4.5%)). Median age at diagnosis differed significantly according to race: (in years, yrs) W: 62.1, H: 57.3, A/PI: 60.5, B: 56.6; P<0.01 for each race vs. W. For all pts, OS was superior in Era 2 vs. Era 1 (5-yr OS: 77% vs. 68%, respectively, P<0.0001). Further, OS was significantly improved for all age groups (<50, 50–59, 60–69, and 70–79 yrs) as well as for males (P=0.0019) and females (P<0.0001) across eras. Interestingly, females had superior OS compared with males in Era 1 (P=0.004), but not in Era 2 (P=0.83). We subsequently compared OS within and across races (see Table). All races, except A/PI, had improved 5-yr OS rates (age adjusted) from Era 1 to Era 2 (W: <0.001, H: 0.049, A/PI: 0.15, B: 0.003). Notably, A/PIs had the highest OS in Era 1, while H had the poorest OS in Era 2. These differences were more evident in males compared with females within each race. Finally, pts with higher SES had improved OS compared with low SES in both eras (P=0.02 in era 1 and <0.0001 in era 2), although OS was improved across eras within low and high SES populations (P<0.0001). Conclusions: Collectively, we identified improved OS in FL across eras, which was apparent for all ages, both sexes, and all races. However, racial disparities persist, including inferior OS for H and superior OS for A/PIs in the contemporary era. The disproportionate improvement in OS over eras and persistent inequality in outcomes based on race warrants continued examination. Disclosures: No relevant conflicts of interest to declare.

Occupations, age and gender: Men and women’s earnings in the Irish labour market

2017 ◽  
Vol 41 (2) ◽  
pp. 276-295
Author(s):  
Tom Turner ◽  
Christine Cross ◽  
Caroline Murphy
Keyword(s):  
Labour Market ◽  
Age Groups ◽  
Policy Implications ◽  
Full Time ◽  
Men And Women ◽  
The Public ◽  
Part Time ◽  
Women's Earnings ◽  
And Gender ◽  
The Impact

While many studies investigate gender wage disparities, few have examined the impact of gender, education, part-time working and sector on earnings for men and women across different occupational groups and for different age groups. The purpose of this article is to undertake a more nuanced approach to further our understanding of the gender pay difference between men and women in different occupations in order to tackle and close this gap. The study’s findings suggest that the labour market is segmented into primary and secondary jobs. Additionally, the earnings returns for education are generally lower for women compared to men and women appear to fare better in the public sector in terms of a lower earnings gap for full-time and part-time employees and higher returns for education compared to women working in the private sector. The article concludes with a discussion of the policy implications.

scholarly journals Type 2 diabetes in older patients: an analysis of the DPV and DIVE databases

2020 ◽  
Vol 11 ◽  
pp. 204201882095829
Author(s):  
Gesine van Mark ◽  
Sascha R. Tittel ◽  
Stefan Sziegoleit ◽  
Franz Josef Putz ◽  
Mesut Durmaz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Older Patients ◽  
Microvascular Complications ◽  
Oldest Old ◽  
Age Groups ◽  
Young Patients ◽  
Severe Hypoglycemia ◽  
Old Patients

Background: The clinical profile differs between old and young patients with type 2 diabetes mellitus (T2DM). We explored, based on a large real-world database, patient and disease characteristics and actual treatment patterns by age. Methods: The analysis was based on the DIVE and DPV registries of patients with T2DM. Patients were analyzed by age groups 50–59 (middle-young), 60–69 (young-old), 70–79 (middle-old), 80–89 (old), and 90 years or more (oldest-old). Results: A total of 396,719 patients were analyzed, of which 17.7% were 50–59 years, 27.7% 60–69 years, 34.3% 70–79 years, 18.3% 80–89 years and 2.0% at least 90 years. We found that (a) T2DM in old and oldest-old patients was characterized much less by the presence of metabolic risk factors such as hypertension, obesity, dyslipidemia and smoking than in younger patients; (b) the HbA1c was much lower in oldest-old than in middle-young patients (7.2 ± 1.6% versus 8.0 ± 2.2%; p < 0.001), but it was associated with higher proportions of patients with severe hypoglycemia (7.0 versus 1.6%; p < 0.001); (c) this was potentially associated with the higher and increasing rates of insulin use in older patients (from 17.6% to 37.6%, p < 0.001) and the particular comorbidity profile of these patients, for example, chronic kidney disease (CKD); (d) patients with late diabetes onset had lower HbA1c values, lower bodyweight and less cardiovascular risk factors; (e) patients with a longer diabetes duration had a considerable increase in macrovascular and even more microvascular complications. Conclusion: In very old patients there is a need for frequent careful routine assessment and a tailored pharmacotherapy in which patient safety is much more important than blood-glucose-lowering efficacy.

scholarly journals Breast Cancer Among the Oldest Old: Tumor Characteristics, Treatment Choices, and Survival

2010 ◽  
Vol 28 (12) ◽  
pp. 2038-2045 ◽  
Author(s):  
Mara A. Schonberg ◽  
Edward R. Marcantonio ◽  
Donglin Li ◽  
Rebecca A. Silliman ◽  
Long Ngo ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Stage ◽  
Oldest Old ◽  
Age Groups ◽  
Breast Conserving Surgery ◽  
Stage I ◽  
Tumor Characteristics ◽  
Data Set ◽  
Younger Women ◽  
The Impact

Purpose Few data are available on breast cancer characteristics, treatment, and survival for women age 80 years or older. Patients and Methods We used the linked Surveillance, Epidemiology and End Results-Medicare data set from 1992 to 2003 to examine tumor characteristics, treatments (mastectomy, breast-conserving surgery [BCS] with radiation therapy or alone, or no surgery), and outcomes of women age 80 years or older (80 to 84, 85 to 89, ≥ 90 years) with stage I/II breast cancer compared with younger women (age 67 to 79 years). We used Cox proportional hazard models to examine the impact of age on breast cancer–related and other causes of death. Analyses were performed within stage, adjusted for tumor and sociodemographic characteristics, treatments received, and comorbidities. Results In total, 49,616 women age 67 years or older with stage I/II disease were included. Tumor characteristics (grade, hormone receptivity) were similar across age groups. Treatment with BCS alone increased with age, especially after age 80. The risk of dying from breast cancer increased with age, significantly after age 80. For stage I disease, the adjusted hazard ratio of dying from breast cancer for women age ≥ 90 years compared with women age 67 to 69 years was 2.6 (range, 2.0 to 3.4). Types of treatments received were significantly associated with age and comorbidity, with age as the stronger predictor (26% of women age ≥ 80 years without comorbidity received BCS alone or no surgery compared with 6% of women age 67 to 79 years). Conclusion Women age ≥ 80 years have breast cancer characteristics similar to those of younger women yet receive less aggressive treatment and experience higher mortality from early-stage breast cancer. Future studies should focus on identifying tumor and patient characteristics to help target treatments to the oldest women most likely to benefit.

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