Cancer Research and Treatment

Original Articles

Clinicopathologic Features and Long-Term Outcomes of Elderly Breast Cancer Patients: Experiences at a Single Institution in Korea: Hee Kyung Kim, Jun Soo Ham, Seonggyu Byeon, Kwai Han Yoo, Ki Sun Jung, Haa-Na Song, Jinhyun Cho, Ji Yun Lee, Sung Hee Lim, Hae Su Kim, Ji-Yeon Kim, Jeong Eon Lee, Seok Won Kim, Seok Jin Nam, Se Kyung Lee, Soo Youn Bae, Jin Seok Ahn, Young-Hyuck Im, Yeon Hee Park; Cancer Res Treat. 2016;48(4):1382-1388. Published online March 11, 2016; DOI: https://doi.org/10.4143/crt.2015.423

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Purpose
The purpose of this study was to assess the tumor characteristics and long-term clinical outcomes of adjuvant treatments after surgery with a curative aim for patients with breast cancer who are 65 years and older. Materials and Methods Patients with breast cancer who underwent curative surgery from 2000 to 2009 were analyzed (n=4,388). Tumor characteristics and survival outcome were compared by dividing the patients into two age groups (< 65 and ≥ 65 years old). The Kaplan-Meier method was used for comparison of survival rates by log-rank test, and a Cox regression model was used to examine the effect of variables.
Results
Among 4,388 patients with invasive breast cancer, 317 patients (7.2%) were 65 years or older and the median age of all patients was 47 years (range, 18 to 91 years). Tumor characteristics were similar between the two age groups, but the older patients were treated less often with adjuvant treatments. During a median follow-up period of 122 months, recurrence-free survival (RFS) was equivalent for patients 65 years and older compared to younger patients, but significantly worse in overall survival (OS) and breast cancer–specific survival (BCSS) (5-year OS, 94.3% vs. 90.5%; p < 0.001 and 5-year BCSS, 94.7% vs. 91.8%; p=0.031). In the multivariate model, age ≥ 65 years old was identified as an independent risk factor for OS and RFS. Conclusion Elderly breast cancer appeared to have worse outcomes with very low prevalence in Korea, despite similar tumor characteristics. More active adjuvant therapies would have a role for aggressive subtypes for fit, elderly patients.

Citations

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HISTOPATHOLOGICAL AND BIOLOGICAL BEHAVIOR OF BREAST CANCER IN ELDERLY KURDISH WOMEN
Kamal Saeed, Shewaz Salih
JOURNAL OF SULAIMANI MEDICAL COLLEGE.2023; 13(4): 11. CrossRef
Analysis of the tumor characteristics in young age breast cancer patients using collaborative stage data of the Korea Central Cancer Registry
Junyup Kim, Seri Hong, Jae Jun Lee, Young-Joo Won, Eun Sook Lee, Han-Sung Kang, Seeyoun Lee, Jai Hong Han, Eun-Gyeong Lee, Heein Jo, Hyun Hee Kim, So-Youn Jung
Breast Cancer Research and Treatment.2021; 187(3): 785. CrossRef
Survival outcomes in elderly Taiwanese women according to breast cancer subtype and lymph node status: A single-center retrospective study
Kung-Hung Lin, Huan-Ming Hsu, Kuo-Feng Hsu, Chi-Hong Chu, Zhi-Jie Hong, Chun-Yu Fu, Yu-Ching Chou, Golshan Mehra, Ming-Shen Dai, Jyh-Cherng Yu, Guo-Shiou Liao, Jason Chia-Hsun Hsieh
PLOS ONE.2021; 16(12): e0261258. CrossRef
Could lymph node evaluation be eliminated in nearly 50% of women with early stage ER/PR positive breast cancer?
Juan Ruiz, Gerson Maldonado, Elizabeth Ablah, Hayrettin Okut, Jared Reyes, Karson Quinn, Patty L. Tenofsky
The American Journal of Surgery.2020; 220(6): 1417. CrossRef
Overall survival of elderly patients with breast cancer is not related to breast-cancer specific survival: A single institution experience in Japan
Haruko Takuwa, Wakako Tsuji, Fumiaki Yotsumoto
Breast Disease.2018; 37(4): 177. CrossRef
Observational study of coagulation activation in early breast cancer: development of a prognostic model based on data from the real world setting
Chiara Mandoj, Laura Pizzuti, Domenico Sergi, Isabella Sperduti, Marco Mazzotta, Luigi Di Lauro, Antonella Amodio, Silvia Carpano, Anna Di Benedetto, Claudio Botti, Francesca Ferranti, Anna Antenucci, Maria Gabriella D’Alessandro, Paolo Marchetti, Silveri
Journal of Translational Medicine.2018;[Epub] CrossRef
Do site and type of metastasis in breast cancer show a changing pattern with increased age? A cross comparison of clinicopathological characteristics between age groups
Majid Akrami, Afrooz Sepahdar, Peyman Arasteh, Sedigheh Tahmasebi, Vahid Zangouri, Azam Askari, Babak Pezeshki, Abdolrasoul Talei
World Journal of Surgical Oncology.2018;[Epub] CrossRef
Predicting Nodal Positivity in Women 70 Years of Age and Older with Hormone Receptor-Positive Breast Cancer to Aid Incorporation of a Society of Surgical Oncology Choosing Wisely Guideline into Clinical Practice
Jessemae L. Welsh, Tanya L. Hoskin, Courtney N. Day, Elizabeth B. Habermann, Matthew P. Goetz, Judy C. Boughey
Annals of Surgical Oncology.2017; 24(10): 2881. CrossRef
Combination of 125I brachytherapy and chemotherapy for unresectable recurrent breast cancer
Qixing Tan, Qinghong Qin, Weiping Yang, Bin Lian, Qinguo Mo, Changyuan Wei
Medicine.2016; 95(44): e5302. CrossRef

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Association between Mutation and Expression of TP53 as a Potential Prognostic Marker of Triple-Negative Breast Cancer: Ji-Yeon Kim, Kyunghee Park, Hae Hyun Jung, Eunjin Lee, Eun Yoon Cho, Kwang Hee Lee, Soo Youn Bae, Se Kyung Lee, Seok Won Kim, Jeong Eon Lee, Seok Jin Nam, Jin Seok Ahn, Young-Hyuck Im, Yeon Hee Park; Cancer Res Treat. 2016;48(4):1338-1350. Published online February 18, 2016; DOI: https://doi.org/10.4143/crt.2015.430

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Purpose
TP53, the most frequently mutated gene in breast cancer, is more frequently altered in HER2-enriched and basal-like breast cancer. However, no studies have clarified the role of TP53 status as a prognostic and predictive marker of triple-negative breast cancer (TNBC).
Materials and Methods
We performed p53 immunohistochemistry (IHC), nCounter mRNA expression assay, and DNA sequencing to determine the relationship between TP53 alteration and clinical outcomes of TNBC patients.
Results
Seventy-seven of 174 TNBC patients were found to harbor a TP53 mutation. Patients with missense mutations showed high protein expression in contrast to patients with deletion mutations (positivity of IHC: wild type vs. missense vs. deletion mutation, 53.6% vs. 89.8% vs. 25.0%, respectively; p < 0.001). TP53 mRNA expression was influenced by mutation status (mRNA expression [median]: wild type vs. missense vs. deletion mutation, 207.36± 132.73 vs. 339.61±143.21 vs. 99.53±99.57,respectively; p < 0.001). According to survival analysis, neither class of mutation nor protein or mRNA expression status had any impact on patient prognosis. In subgroup analysis, low mRNA expression was associated with poor prognosis in patientswith a TP53 missense mutation (5-year distantrecurrence-free survival [5Y DRFS]: low vs. high, 50.0% vs. 87.8%; p=0.009), while high mRNA expression with a TP53 deletion mutation indicated poor prognosis (5Y DRFS: low vs. high, 91.7% vs. 75.0%; p=0.316).
Conclusion
Association between TP53 mutation and expression indicates a potential prognostic marker of TNBC; hence both DNA sequencing and mRNA expression analysis may be required to predict the prognosis of TNBC patients.

Citations

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The Clinical Impact of 21-Gene Recurrence Score on Treatment Decisions for Patients with Hormone Receptor-Positive Early Breast Cancer in Korea: Moo Hyun Lee, Wonshik Han, Jeong Eon Lee, Ku Sang Kim, Heeseung Park, Jongjin Kim, Soo Youn Bae, Hyun Joo Shin, Jong Won Lee, Eun Sook Lee; Cancer Res Treat. 2015;47(2):208-214. Published online September 11, 2014; DOI: https://doi.org/10.4143/crt.2013.223

Abstract PDF PubReader ePub

Purpose
The 21-gene (Oncotype DX) recurrence score (RS) assay is useful in predicting the benefits of adjuvant chemotherapy for early breast cancer patients and is widely used in Western countries. However, to date, it has not gained much popularity in East Asia. We analyzed the results from five institutions’ experience from using the 21-gene assay and examined the impact of assay results on decision making of chemotherapy in Korean breast cancer patients and the associations between RS and clinicopathologic characteristics.
Materials and Methods
The 21-gene assay was performed on 212 patients with estrogen receptor-positive early breast cancer in five institutions. Each center made systemic treatment decisions both before and after the knowledge of assay results.
Results
Among the 212 patients, 132 (62.3%) had a low RS of < 18, 60 (28.3%) had an intermediate RS of 18-30, and 20 (9.4%) had a high RS of ≥ 31. Histologic grade, presence of micrometastases, Ki-67, and presence of lymphatic invasion were statistically associated with the RS results. Treatment decisions were changed in 115 of 212 patients (54.2%) in 109 of 212 (51.4%) from chemotherapy plus hormone therapy to hormone therapy, and in six of 212 (2.8%) from hormone therapy to chemotherapy plus hormone therapy.
Conclusion
The 21-gene breast cancer assay proved to have a significant impact on treatment decision- making. The test reduces chemotherapy use in more than 50% of Korean estrogen receptor-positive, early breast cancer patients.

Citations

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The Rochester Modified Magee Algorithm (RoMMa): An Outcomes Based Strategy for Clinical Risk-Assessment and Risk-Stratification in ER Positive, HER2 Negative Breast Cancer Patients Being Considered for Oncotype DX® Testing
Bradley M. Turner, Brian S. Finkelman, David G. Hicks, Numbere Numbereye, Ioana Moisini, Ajay Dhakal, Kristin Skinner, Mary Ann G. Sanders, Xi Wang, Michelle Shayne, Linda Schiffhauer, Hani Katerji, Huina Zhang
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