罹患激素受体阳性乳腺癌的绝经后女性患者的诊断时年龄与疾病特异性死亡率之间相关性

Context:

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.

Design, Setting, and Patients:

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 65years (n=5349), 65 to 74years (n=3060), and 75years or older (n=1357).

Main Outcome Measures:

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

Conclusion:

Among postmenopausal women with hormone receptor–positive breast cancer, increasing age was associated with a higher disease-specific mortality.