Association between age at diagnosis and disease-specific mortality among postmenopausal women with hormone receptor-positive breast cancer.
BACKGROUND
In addition to classic tumor-related prognostic factors, patient characteristics may be associated with breast cancer outcome.


OBJECTIVE
To assess the association between age at diagnosis and breast cancer outcome in postmenopausal women with hormone receptor-positive breast cancer.


METHODS
Study analysis of 9766 patients enrolled in the TEAM (Tamoxifen Exemestane Adjuvant Multinational) randomized clinical trial between January 2001 and January 2006. Age at diagnosis was categorized as younger than 65 years (n=5349), 65 to 74 years (n=3060), and 75 years or older (n=1357).


METHODS
Primary end point was disease-specific mortality; secondary end points were other-cause mortality and breast cancer relapse.


RESULTS
During median follow-up of approximately 5.1 years, there were a total of 1043 deaths. Disease-specific mortality, as a proportion of all-cause mortality, decreased with categorical age group (78% [<65 years], 56% [65-74 years], and 36% [≥75 years]; P < .001). In multivariable analyses, compared with patients younger than 65 years, disease-specific mortality increased with age for patients aged 65 to 74 years (hazard ratio [HR], 1.25; 95% CI, 1.01-1.54); and patients aged 75 years or older (HR, 1.63; 95% CI, 1.23-2.16) (P < .001). Similarly, breast cancer relapse increased with age for patients aged 65-74 years (HR, 1.07; 95% CI, 0.91-1.25 and patients aged 75 years or older (HR, 1.29; 95% CI, 1.05-1.60) (P = .06). Other-cause mortality increased with age in patients aged 65 to 74 years (HR, 2.66; 95% CI, 1.96-3.63) and patients aged 75 years or older (HR, 7.30; 95% CI, 5.29-10.07) (P < .001).


CONCLUSIONS
Among postmenopausal women with hormone receptor-positive breast cancer, increasing age was associated with a higher disease-specific mortality.
Department of Surgical Oncology, Leiden University Medical Center, Albinusdreef 2, PO Box 9600, 2300 RC Leiden, The Netherlands.
Willemien
W
van de Water
Christos
C
Markopoulos
Cornelis J H
CJ
van de Velde
Caroline
C
Seynaeve
Annette
A
Hasenburg
Daniel
D
Rea
Hein
H
Putter
Johan W R
JW
Nortier
Anton J M
AJ
de Craen
Elysée T M
ET
Hille
Esther
E
Bastiaannet
Peyman
P
Hadji
Rudi G J
RG
Westendorp
Gerrit-Jan
GJ
Liefers
Stephen E
SE
Jones
D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D000730:Androstadienes / Q000008:administration & dosage; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage; D001943:Breast Neoplasms / Q000737:chemistry / Q000188:drug therapy / Q000401:mortality*; D002423:Cause of Death; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D011960:Receptors, Estrogen / Q000032:analysis; D011980:Receptors, Progesterone / Q000032:analysis; D012306:Risk; D013629:Tamoxifen / Q000008:administration & dosage
D000730:Androstadienes; D018931:Antineoplastic Agents, Hormonal; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D013629:Tamoxifen; C056516:exemestane