Outcomes for elderly breast cancer patients in Louisiana.

e11030 Background: Elderly breast cancer patients, compared to younger breast cancer patients, are diagnosed with a higher stage of disease. They are also found to undergo less surgery, receive more frequently hormonal treatment and have decreased relative survival. The interest of this study was to examine if differences in treatment and survival between >65 year old and <65 year old patients in Louisiana. Methods: The SEER database was searched and all cases of female breast cancer in the state of Louisiana between 2000 and 2008 were analyzed. Data was stratified by age group and year of occurrence. SEER definitions for breast cancer, surgery, chemotherapy, elderly, young populations, radiation therapy, breast conservative surgery were applied. Results: The state prevalence of localized breast cancer is lower compared to the national rate (128.5 vs. 144 p <0.001). The rate of regional breast disease is much higher in Louisiana patients than national average rate (69.7 vs. 57.9 p <0.001). There is no difference in disseminated disease. When the elderly group is compared to non-elderly group there was a difference in localized disease (non-elderly 59.9% vs. elderly 64.98 P<0.001). There was a difference also in regional disease (non-elderly 33.75% vs. elderly 25.02%). No difference was noted in rates of disseminated disease (non-elderly 5.03% vs. elderly 5.77%). The elderly group was offered less surgery compared to the young group (11.39% vs. 6.68% in the young group, p<0.005). In terms of radiation therapy the elderly group receive more general radiation interventions than the young group (65.97% vs. 53.86 p <0.005). In relation to type of radiotherapy (beam radiation and radioactive implants) there were no differences between the two groups. Mortality rates for the elderly group was higher in Louisiana compared to the national average. This difference was more remarkable in the >85 age group (127.8 vs. 118.5, p<0.001) Conclusions: Differences in treatment modalities and management interventions between young and elderly breast cancer in Louisiana patients were observed. Mortality is higher among elderly breast cancer patients in Louisiana compared to national average. Further studies are needed to review the these regional differences.

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PAI-1 is independent prognostic factor in the elderly breast cancer patients

European Journal of Cancer ◽

10.1016/s0959-8049(02)80358-6 ◽

2002 ◽

Vol 38 (11) ◽

pp. S111

Author(s):

B Pajk

Keyword(s):

Breast Cancer ◽

Prognostic Factor ◽

Cancer Patients ◽

The Elderly ◽

Independent Prognostic Factor ◽

Breast Cancer Patients ◽

Pai 1

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The rate of ovarian failure in 12 months following adjuvant chemotherapy in breast cancer patients according to age group

10.26226/morressier.573c1514d462b80296c98c95 ◽

2016 ◽

Author(s):

Jae Jun Shin

Keyword(s):

Breast Cancer ◽

Adjuvant Chemotherapy ◽

Cancer Patients ◽

Ovarian Failure ◽

Age Group ◽

Breast Cancer Patients

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Changes in peripheral immune cells after intraoperative radiation therapy in low-risk breast cancer

Journal of Radiation Research ◽

10.1093/jrr/rraa083 ◽

2020 ◽

Vol 62 (1) ◽

pp. 110-118

Author(s):

Isabel Linares-Galiana ◽

Miguel Angel Berenguer-Frances ◽

Rut Cañas-Cortés ◽

Monica Pujol-Canadell ◽

Silvia Comas-Antón ◽

...

Keyword(s):

Breast Cancer ◽

Radiation Therapy ◽

Single Dose ◽

Cancer Patients ◽

Antitumor Immunity ◽

Low Risk ◽

Intraoperative Radiation Therapy ◽

Breast Cancer Patients ◽

Intraoperative Radiation ◽

Risk Breast Cancer

Abstract A detailed understanding of the interactions and the best dose-fractionation scheme of radiation to maximize antitumor immunity have not been fully established. In this study, the effect on the host immune system of a single dose of 20 Gy through intraoperative radiation therapy (IORT) on the surgical bed in low-risk breast cancer patients undergoing conserving breast cancer has been assessed. Peripheral blood samples from 13 patients were collected preoperatively and at 48 h and 3 and 10 weeks after the administration of radiation. We performed a flow cytometry analysis for lymphocyte subpopulations, natural killer cells (NK), regulatory T cells (Treg) and myeloid-derived suppressor cells (MDSCs). We observed that the subpopulation of NK CD56+high CD16+ increased significantly at 3 weeks after IORT (0.30–0.42%, P < 0.001), while no changes were found in immunosuppressive profile, CD4+CD25+Foxp3+Helios+ Treg cells, granulocytic MDSCs (G-MDSCs) and monocytic MDSCs (Mo-MDSCs). A single dose of IORT may be an effective approach to improve antitumor immunity based on the increase in NK cells and the non-stimulation of immunosuppressive cells involved in immune escape. These findings support future combinations of IORT with immunotherapy, if they are confirmed in a large cohort of breast cancer patients.

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Is there a worthwhile value in personalizing radiation therapy for breast cancer patients? Time for a new paradigm in the older adult population

Expert Review of Precision Medicine and Drug Development ◽

10.1080/23808993.2021.1897463 ◽

2021 ◽

pp. 1-4

Author(s):

Viola Salvestrini ◽

Matteo Mariotti ◽

Marco Banini ◽

Carlotta Becherini ◽

Luca Visani ◽

...

Keyword(s):

Breast Cancer ◽

Radiation Therapy ◽

Cancer Patients ◽

Older Adult ◽

Adult Population ◽

Breast Cancer Patients ◽

New Paradigm ◽

Older Adult Population

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Breast Cancer in the Elderly

Journal of Clinical Oncology ◽

10.1200/jco.2006.10.2079 ◽

2007 ◽

Vol 25 (14) ◽

pp. 1882-1890 ◽

Cited By ~ 117

Author(s):

Diana Crivellari ◽

Matti Aapro ◽

Robert Leonard ◽

Gunter von Minckwitz ◽

Etienne Brain ◽

...

Keyword(s):

Breast Cancer ◽

Clinical Trials ◽

Life Expectancy ◽

Cancer Patients ◽

Disease Free Survival ◽

Cost Benefit ◽

The Elderly ◽

Breast Cancer Patients ◽

Younger Women ◽

Based Medicine

Screening and adjuvant postoperative therapies have increased survival among women with breast cancer. These tools are seldom applied in elderly patients, although the usually reported incidence of breast cancer is close to 50% in women 65 years or older, reaching 47% after 70 years in the updated Surveillance, Epidemiology, and End Results (SEER) database. Elderly breast cancer patients, even if in good medical health, were frequently excluded from adjuvant clinical trials. Women age 70 years who are fit actually have a median life expectancy of 15.5 years, ie, half of them will live much longer and will remain exposed for enough time to the potentially preventable risks of a relapse and specific death. In the last few years, a new concern about this issue has developed. Treatment now faces two major end points, as in younger women: to improve disease-free survival in the early stages, and to palliate symptoms in advanced disease. However, in both settings, the absolute benefit of treatment is critical because protecting quality of life and all its related aspects (especially functional status and independence), is crucial in older persons who have more limited life expectancy. Furthermore, the new hormonal compounds (aromatase inhibitors) and chemotherapeutic drugs (capecitabine, liposomal doxorubicin), are potentially less toxic than and equally as effective as older more established therapies. These new treatments bring new challenges including higher cost, and defining their benefit in elderly breast cancer must include an analysis of the cost/benefit ratio. These issues emphasize the urgent need to develop and support clinical trials for this older population of breast cancer patients both in the adjuvant and metastatic settings, a move that will take us from a prejudiced, age-based medicine to an evidence-based medicine.

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