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70岁及以上老年患者的乳腺癌:治疗依从性和肿瘤学结局

Breast Cancer in Older Patients Aged 70 Years and Above: Treatment Adherence and Oncologic Outcomes.

作者信息

Kim Ji Hye, Kim Yong Yeup, Chung Jai Hyun, Kim Woo Young, Lee Jae Bok, Woo Sang Uk

机构信息

Division of Breast and Endocrine Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.

出版信息

J Breast Cancer. 2025 Apr;28(2):99-107. doi: 10.4048/jbc.2024.0190. Epub 2025 Feb 27.

Abstract

PURPOSE

The incidence of breast cancer in older females is increasing with increased life expectancy. This study analyzed tumor characteristics and oncological outcomes in patients aged ≥ 70 years compared to patients in a younger postmenopausal group, in conjunction with their adherence to treatment guidelines.

METHODS

Patients aged ≥ 50 years, newly diagnosed with breast cancer, were divided into two age categories: ≥ 70 years and 50-69 years. All patients underwent curative surgery at Korea University Guro Hospital between January 2009 and December 2019. Clinical data on tumor subtype, histopathological grade, and clinical stage, along with treatment details were collected. Disease-free survival, distant recurrence-free survival, and breast cancer-specific survival rates were determined.

RESULTS

Of 1,199 patients, 166 (13.8%) were ≥ 70 years at the time of surgery. The disease-free, distant recurrence-free, and breast cancer-specific survival rates were significantly lower in patients aged ≥ 70 years ( < 0.05). In a subgroup analysis, human epidermal growth factor receptor 2-positive tumors were the only subtype with a statistically significant difference in survival outcomes, and adherence to the guidelines was strongly linked to a better prognosis.

CONCLUSION

Patients aged ≥ 70 years had lower disease-free, distant recurrence-free, and breast cancer-specific survival rates compared to younger postmenopausal patients aged 50-69 years. With the continuous increase in life expectancy and advances in healthcare, it is critical to optimize treatment strategies for older patients with breast cancer to improve survival outcomes and enhance their quality of life.

摘要

目的

随着预期寿命的增加,老年女性乳腺癌的发病率也在上升。本研究分析了70岁及以上患者与年轻绝经后组患者的肿瘤特征和肿瘤学结局,并结合他们对治疗指南的遵循情况。

方法

年龄≥50岁、新诊断为乳腺癌的患者分为两个年龄组:≥70岁和50 - 69岁。2009年1月至2019年12月期间,所有患者均在韩国大学古罗医院接受了根治性手术。收集了肿瘤亚型、组织病理学分级和临床分期的临床数据以及治疗细节。确定了无病生存率、远处无复发生存率和乳腺癌特异性生存率。

结果

在1199例患者中,166例(13.8%)在手术时年龄≥70岁。70岁及以上患者的无病生存率、远处无复发生存率和乳腺癌特异性生存率显著较低(<0.05)。在亚组分析中,人表皮生长因子受体2阳性肿瘤是生存结局唯一具有统计学显著差异的亚型,并且遵循指南与更好的预后密切相关。

结论

与50 - 69岁的年轻绝经后患者相比,70岁及以上患者的无病生存率、远处无复发生存率和乳腺癌特异性生存率较低。随着预期寿命的不断增加和医疗保健的进步,优化老年乳腺癌患者的治疗策略以改善生存结局并提高其生活质量至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b14/12046351/c8fc9ab01e46/jbc-28-99-g001.jpg

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