Study on Early-Stage Breast Cancer: Age Influence on Chemotherapy Decision

Summary:

The study by Hoffmann AS. et al. titled "Impact of age on indication for chemotherapy in early breast cancer patients: results from 104 German institutions from 2008 to 2017."

About the Study:

The decision to administer chemotherapy to patients with early-stage breast cancer depends on their individual risk, where tumor biology plays a significant role. A German research group investigated how the age of patients influences treatment decisions, treatment methods, and outcomes.

Methodology:

Researchers from the University of Heidelberg analyzed data from the Eastern German Breast Center. The study included 124,084 women who received treatment for early-stage breast cancer at one of 104 German clinics from 2008 to 2017. Women were divided into six age groups: ≤ 29 years, 30-39 years, 40-49 years, 50-59 years, 60-69 years, and ≥ 70 years.

Results:

• Approximately 82% of breast cancer patients were older than 50 years.
• Most women, regardless of age, had tumor stage T1/T2 and negative lymph node status (meaning no lymph node involvement).
• Tumor stage T3/T4 (larger than 5 cm) was more common in the oldest age group.
• Unfavorable tumor subtypes (e.g., HR− HER2−) were more frequent among younger women, while favorable subtypes (e.g., HR+ HER2−) predominated among older women.
• Out of the total, 46,274 women (37.3%) received chemotherapy.
• Chemotherapy was administered neoadjuvantly (before surgery) in 14,783 cases (33%) and adjuvantly (after surgery) in 29,982 cases (67%).
• Younger women more frequently underwent chemotherapy (≤ 29 years: 74.2%; 30-39 years: 71.3%) compared to older women (60-69 years: 37.5%; ≥ 70 years: 17.6%), and it was more often neoadjuvant in younger women (≤ 29 years: 66.9%; 30-39 years: 56%) compared to older women (60-69 years: 25.5%; ≥ 70 years: 22.8%).
• Complete response after neoadjuvant chemotherapy was more common in younger patients (≤ 29 years: 28.4% vs. ≥ 70 years: 16.9%), especially noticeable in HER2-positive subtypes.

Conclusions:

Researchers concluded that in Germany, the decision to prescribe chemotherapy for early-stage breast cancer and the choice of treatment regimen significantly depend on the patient's age. Younger women are more likely to receive (neoadjuvant) chemotherapy and more often achieve a complete pathological response compared to older women.

For more detailed information on the original study, you can follow this link:

https://link.springer.com/article/10.1007/s00404-022-06902-9

Hoffmann AS. et al. Impact of age on indication for chemotherapy in early breast cancer patients: results from 104 German institutions from 2008 to 2017. Arch Gynecol Obstet 2023; 308: 219-229.