Breast Cancer in Elderly Caucasian Women-An Institution-Based Study of Correlation between Breast Cancer Prognostic Markers, TNM Stage, and Overall Survival.
There is still a paucity of data on how breast cancer (BC) biology influences outcomes in elderly patients. We evaluated whether ER/PR/HER2 subtype and TNM stage of invasive BC had a significant impact on overall survival (OS) in a cohort of 232 elderly Caucasian female patients (≥70 year old (y/o)) from our institution over a ten-year interval (January 1998-July 2008). Five ER/PR/HER2 BC subtypes classified per 2011 St. Gallen International Expert Consensus recommendations were further subclassified into three subtypes (traditionally considered "favorable" subtype-ER+/PR+/HER2-, and traditionally considered "unfavorable" BC subtypes: HER2+ and triple negative). OS was measured comparing these categories using Kaplan Meier curves and Cox regression analysis, when controlled for TNM stage. The majority of our patients (178/232 = 76.8%) were of the "favorable" BC subtype; 23.2% patients were with "unfavorable" subtype (HER2+ = 12% (28/232) and triple negative = 11.2% (26/232)). Although a trend for better OS was noted in HER2+ patients (68%) vs. 56% in ER+/PR+ HER2- or 58% in triple negative patients, "favorable" BC subtype was not significantly predictive of better OS (p = 0.285). TNM stage was predictive of OS (p < 0.001). These results are similar to our published studies on Caucasian BC patients of all ages in which ER/PR/HER2 status was not predictive of OS, irrespective of classification system used.
Department of Pathology, Graduate School of Medicine, University of Tennessee Medical Center at Knoxville, Knoxville, TN 37920, USA. aorucevic@mc.utmck.edu.
Amila
A
Orucevic
Department of Pathology, Graduate School of Medicine, University of Tennessee Medical Center at Knoxville, Knoxville, TN 37920, USA. mcurzon@mc.utmck.edu.
Matthew
M
Curzon
Department of Family Medicine, Graduate School of Medicine, University of Tennessee Medical Center at Knoxville, Knoxville, TN 37920, USA. ccurzon@mc.utmck.edu.
Christina
C
Curzon
Department of Surgery, Graduate School of Medicine, University of Tennessee Medical Center at Knoxville, Knoxville, TN 37920, USA. rheidel@mc.utmck.edu.
Robert E
RE
Heidel
Department of Surgery, Graduate School of Medicine, University of Tennessee Medical Center at Knoxville, Knoxville, TN 37920, USA. jmcloughlin@mc.utmck.edu.
James M
JM
McLoughlin
Department of Medicine, Graduate School of Medicine, University of Tennessee Medical Center at Knoxville, Knoxville, TN 37920, USA. tpanella@mc.utmck.edu.
Timothy
T
Panella
Department of Surgery, Graduate School of Medicine, University of Tennessee Medical Center at Knoxville, Knoxville, TN 37920, USA. jlbell@mc.utmck.edu.
John
J
Bell
Caucasian women; TNM staging; breast cancer prognostic markers; overall survival