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Different Patterns in the Prognostic Value of Age for Breast Cancer-Specific Mortality Depending on Hormone Receptor Status: A SEER Population-Based Analysis

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Few studies have been undertaken to evaluate the prognostic value of age at diagnosis for determining breast cancer survival in a large population.

Methods

Using the U.S. National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database consisting of 18 population-based cancer registries, this study identified 331,969 female patients with a diagnosis of breast cancer from 1 January 1990, to 31 December 31. Breast cancer-specific mortality (BCSM) was compared among patients in different age groups using Kaplan–Meier plots. The Cox proportional hazards model was used for multivariate analysis.

Results

In the multivariate analysis, the hazard ratios (HRs) of BCSM in the different age groups formed a U-shaped curve, with patients younger than 30 years and patients older than 79 years experiencing the worst survival rates (HR, 1.19; 95 % confidence interval [CI], 1.06–1.33; P = 0.003 and HR, 2.16; 95 % CI, 2.05–2.27; P < 0.001, with age 50–59 years as the reference, respectively). When the interaction between age at diagnosis and hormone receptor (HoR) status for prediction of BCSM was further analyzed, the findings showed that in the HoR-positive group, patients younger than 30 years and patients older than 79 years had the worst survival rates (HR, 1.52; 95 % CI, 1.30–1.76; P < 0.001 and HR, 2.07; 95 % CI, 1.94–2.20; P < 0.001, respectively), whereas patients ages 40 to 49 years had the best survival rate (HR, 0.93; 95 % CI, 0.89–0.98; P = 0.005). This pattern, however, was different in the HoR-negative group. Patients younger than 60 years had nearly the same BCSM (P = 0.356, 0.199, and 0.036 for ages <30 years, 30–39 years, and 40–49 years, respectively), with BCSM starting to increase with age only for patients older than 60 years and peaking for patients older than 79 years (HR, 2.39; 95 % CI, 2.20–2.59; P < 0.001).

Conclusions

The study findings show different patterns in the prognostic value of age for determining BCSM, depending on the HoR status. These data underscore the importance of age-specific studies for different HoR groups to individualize treatment and improve outcomes for breast cancer patients.

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Acknowledgments

We thank Drs. Jiong Wu, Gen-Hong Di, and Guang-Yu Liu for their technical assistance with the data analysis. This work was supported by the National Natural Science Foundation of China (81370075, 81001169), the Training Plan for Excellent Talents in the Shanghai Municipality Health System (for K.D.Y.), the Research and Innovation Project of the Shanghai Municipal Education Commission (2014, for K.D.Y.), the Shanghai International Science and Technique Cooperation Foundation (12410707700), the International S&T Cooperation Program of China (ISTCP No. 09), and the Shanghai Key Laboratory of Breast Cancer (12DZ2260100). The funders had no role in the study design, data collection and analysis, or the decision to prepare and publish this study.

Disclosure

The authors declare no conflicts of interest.

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Authors and Affiliations

  1. Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, People’s Republic of China

    Yi-Rong Liu MD, Yi-Zhou Jiang MD, Ke-Da Yu MD, PhD & Zhi-Ming Shao MD, PhD

  2. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People’s Republic of China

    Yi-Rong Liu MD, Yi-Zhou Jiang MD, Ke-Da Yu MD, PhD & Zhi-Ming Shao MD, PhD

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  1. Yi-Rong Liu MD
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  2. Yi-Zhou Jiang MD
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Correspondence to Yi-Zhou Jiang MD or Zhi-Ming Shao MD, PhD.

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Yi-Rong Liu and Yi-Zhou Jiang have contributed equally.

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Liu, YR., Jiang, YZ., Yu, KD. et al. Different Patterns in the Prognostic Value of Age for Breast Cancer-Specific Mortality Depending on Hormone Receptor Status: A SEER Population-Based Analysis. Ann Surg Oncol 22, 1102–1110 (2015). https://doi.org/10.1245/s10434-014-4108-5

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  • DOI: https://doi.org/10.1245/s10434-014-4108-5

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