Age exerts a continuous effect in the outcomes of Asian breast cancer patients treated with breast-conserving therapy

Cancer Communications

Cindy Lim¹  Wei Ying Tham¹  Wen Long Nei¹  Fuh Yong Wong¹  Hui Miao² 

[1] Division of Radiation Oncology, National Cancer Centre Singapore, Singapore, Singapore;Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore

关键词: Breast cancer;    Breast-conserving therapy;    Locoregional recurrence;    Breast cancer-specific survival;    Breast cancer-free survival;    Younger age;   

DOI  :  10.1186/s40880-018-0310-3

学科分类：肿瘤学

来源: Springer

【 摘 要 】

Asians are diagnosed with breast cancer at a younger age than Caucasians are. We studied the effect of age on locoregional recurrence and the survival of Asian breast cancer patients treated with breast-conserving therapy. Medical records of 2492 patients treated with breast-conserving therapy between 1989 and 2012 were reviewed. The Kaplan–Meier method was used to estimate locoregional recurrence, breast cancer-free survival, and breast cancer-specific survival rates. These rates were then compared using log-rank tests. Outcomes and age were modeled by Cox proportional hazards. Fractional polynomials were then used to test for non-linear relationships between age and outcomes. Patients ≤ 40 years old were more likely to have locoregional recurrence than were older patients (Hazard ratio [HR] = 2.32, P < 0.001). Locoregional recurrence rates decreased year-on-year by 4% for patients with luminal-type breast cancers, compared with 8% for those with triple-negative cancers. Similarly, breast cancer-free survival rates increased year-on-year by 4% versus 8% for luminal-type and triple-negative cancers, respectively. Breast cancer-specific survival rates increased with age by 5% year-on-year. Both breast cancer-free survival and breast cancer-specific survival rates in patients with luminal cancers exhibited a non-linear (“L-shaped”) relationship—where decreasing age at presentation was associated with escalating risks of relapse and death. The influence of age on overall survival was confounded by competing non-cancer deaths in older women, resulting in a “U-shaped” relationship. Young Asian breast cancer patients have a continuous year-on-year increase in rates of disease relapse and cancer deaths compared with older patients with no apparent threshold.

【 授权许可】

CC BY