Breast Cancer Research and Treatment

, Volume 134, Issue 2, pp 853–857 | Cite as

Long-term survival of older breast cancer patients: population-based estimates over three decades

  • Bindu Kanapuru
  • William B. Ershler
  • Charles Hesdorffer
  • Ahmedin Jemal
  • Jerome W. Yates
Epidemiology

Abstract

Significant progress has been made in the treatment of breast cancer. However, treatment effect on survival in older patients, particularly the “oldest old” (85+ years), with breast cancer is not clear. Data from the Surveillance, Epidemiology, and End Results databases were used to determine relative survival of older patients with breast cancer for up to 9 years following diagnosis. We compared trends in survival and stage distribution in the years 1977–1986, 1987–1996, and 1997–2006 in patients from 65 to 74, 75 to 84, and 85+ years of age. Between 1977–1986 and 1997–2006, 1 year survival increased from 94.9 to 97.9 %, 93.6 to 96.7 %, and 88.5 to 93.5 % in the 65–74, 75–84, and 85+ age groups, respectively. Survival gains increased with each year in all three age groups with the largest improvement seen at 9 years of follow-up. Although the “oldest old” had the lowest survival rates, improvement in survival was greatest in this age group with greater than 20 % increase in survival at 9 years. There was an increased diagnosis of localized breast cancer and decrease in regional disease in all age groups over the three decades. In conclusion, relative survival for older patients has increased considerably in the interval between 1977 and 2006, with the largest improvement seen in those 85 years and older. These results likely indicate that the benefit from advances in therapy and supportive care also extends to older patients with breast cancer, including the ‘oldest old’, but the impact of early diagnosis on survival requires further clarification.

Keywords

Breast cancer Survival Aging SEER 

References

  1. 1.
    Rosso S, Gondos A, Zanetti R et al (2010) Up-to-date estimates of breast cancer survival for the years 2000–2004 in 11 European countries: the role of screening and a comparison with data from the United States. Eur J Cancer 46:3351–3357PubMedCrossRefGoogle Scholar
  2. 2.
    Fried LP, Tangen CM, Walston J et al (2001) Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 56:M146–M156PubMedCrossRefGoogle Scholar
  3. 3.
    Yancik R, Wesley MN, Ries LA et al (2001) Effect of age and comorbidity in postmenopausal breast cancer patients aged 55 years and older. JAMA 285:885–892PubMedCrossRefGoogle Scholar
  4. 4.
    Smith BD, Smith GL, Hurria A et al (2009) Future of cancer incidence in the United States: burdens upon an aging, changing nation. J Clin Oncol 27:2758–2765PubMedCrossRefGoogle Scholar
  5. 5.
    Cherubini A, Del Signore S, Ouslander J et al (2010) Fighting against age discrimination in clinical trials. J Am Geriatr Soc 58:1791–1796PubMedCrossRefGoogle Scholar
  6. 6.
    Horner MJ, Ries LSG, Krapcho M, Neyman N, Aminou R, Howlader N, Altekruse SF, Feuer EJ, Huang L, Mariotto A, Miller BA, Lewis DR, Eisner MP, Stinchcomb DG, Edwards BK (eds) (2009) SEER cancer statistics review, 1975–2006. National Cancer Institute, Bethesda. http://seer.cancer.gov/csr/1975_2006/. Based on November 2008 SEER data submission, posted to the SEER web site
  7. 7.
    Berry DA, Cronin KA, Plevritis SK et al (2005) Effect of screening and adjuvant therapy on mortality from breast cancer. N Engl J Med 353:1784–1792PubMedCrossRefGoogle Scholar
  8. 8.
    Mariotto A, Feuer EJ, Harlan LC et al (2002) Trends in use of adjuvant multi-agent chemotherapy and tamoxifen for breast cancer in the United States: 1975–1999. J Natl Cancer Inst 94:1626–1634PubMedCrossRefGoogle Scholar
  9. 9.
    Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) (2005) Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials. Lancet 365:1687–1717CrossRefGoogle Scholar
  10. 10.
    BIG 1-98 Collaborative Group, Mouridsen H, Giobbie-Hurder A, Goldhirsch A et al (2009) Letrozole therapy alone or in sequence with tamoxifen in women with breast cancer. N Engl J Med 361:766–776Google Scholar
  11. 11.
    Giordano SH, Duan Z, Kuo YF et al (2006) Use and outcomes of adjuvant chemotherapy in older women with breast cancer. J Clin Oncol 24:2750–2756PubMedCrossRefGoogle Scholar
  12. 12.
    Muss HB, Berry DA, Cirrincione CT et al (2009) Adjuvant chemotherapy in older women with early-stage breast cancer. N Engl J Med 360:2055–2065PubMedCrossRefGoogle Scholar
  13. 13.
    Randolph WM, Goodwin JS, Mahnken JD et al (2002) Regular mammography use is associated with elimination of age-related disparities in size and stage of breast cancer at diagnosis. Ann Intern Med 137:783–790PubMedGoogle Scholar
  14. 14.
    Badgwell BD, Giordano SH, Duan ZZ et al (2008) Mammography before diagnosis among women age 80 years and older with breast cancer. J Clin Oncol 26:2482–2488PubMedCrossRefGoogle Scholar
  15. 15.
    Schonberg MA, Marcantonio ER, Li D et al (2010) Breast cancer among the oldest old: tumor characteristics, treatment choices, and survival. J Clin Oncol 28:2038–2045PubMedCrossRefGoogle Scholar
  16. 16.
    Vercelli M, Capocaccia R, Quaglia A et al (2000) Relative survival in elderly European cancer patients: evidence for health care inequalities. The EUROCARE Working Group. Crit Rev Oncol Hematol 35:161–179PubMedCrossRefGoogle Scholar
  17. 17.
    Bouchardy C, Rapiti E, Fioretta G et al (2003) Undertreatment strongly decreases prognosis of breast cancer in elderly women. J Clin Oncol 21:3580–3587PubMedCrossRefGoogle Scholar

Copyright information

© • Springer Science+Business Media, LLC (outside the USA)  2012

Authors and Affiliations

  • Bindu Kanapuru
    • 1
    • 2
  • William B. Ershler
    • 2
  • Charles Hesdorffer
    • 1
  • Ahmedin Jemal
    • 3
  • Jerome W. Yates
    • 1
    • 2
  1. 1.Intramural Research ProgramNational Institute on AgingBaltimoreUSA
  2. 2.Institute for Advanced Studies on AgingFalls ChurchUSA
  3. 3.Surveillance BranchAmerican Cancer SocietyAtlantaUSA

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