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McGuire A, Brown JAL, Malone C, McLaughlin R, Kerin MJ. Effects of age on the detection and management of breast cancer. Cancers (Basel) 2015; 7:908-29. [PMID: 26010605 PMCID: PMC4491690 DOI: 10.3390/cancers7020815] [Citation(s) in RCA: 203] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 05/12/2015] [Indexed: 12/15/2022] Open
Abstract
Currently, breast cancer affects approximately 12% of women worldwide. While the incidence of breast cancer rises with age, a younger age at diagnosis is linked to increased mortality. We discuss age related factors affecting breast cancer diagnosis, management and treatment, exploring key concepts and identifying critical areas requiring further research. We examine age as a factor in breast cancer diagnosis and treatment relating it to factors such as genetic status, breast cancer subtype, hormone factors and nodal status. We examine the effects of age as seen through the adoption of population wide breast cancer screening programs. Assessing the incidence rates of each breast cancer subtype, in the context of age, we examine the observed correlations. We explore how age affects patient's prognosis, exploring the effects of age on stage and subtype incidence. Finally we discuss the future of breast cancer diagnosis and treatment, examining the potential of emerging tests and technologies (such as microRNA) and how novel research findings are being translated into clinically relevant practices.
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Affiliation(s)
- Andrew McGuire
- Discipline of Surgery, School of Medicine, National University of Ireland, Galway, Ireland.
| | - James A L Brown
- Discipline of Surgery, School of Medicine, National University of Ireland, Galway, Ireland.
| | - Carmel Malone
- Discipline of Surgery, School of Medicine, National University of Ireland, Galway, Ireland.
| | - Ray McLaughlin
- Discipline of Surgery, School of Medicine, National University of Ireland, Galway, Ireland.
| | - Michael J Kerin
- Discipline of Surgery, School of Medicine, National University of Ireland, Galway, Ireland.
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Barco I, Chabrera C, García Font M, Gimenez N, Fraile M, Lain JM, Piqueras M, Vidal MC, Torras M, González S, Pessarrodona A, Barco J, Cassadó J, García Fernández A. Comparison of Screened and Nonscreened Breast Cancer Patients in Relation to Age: A 2-Institution Study. Clin Breast Cancer 2015; 15:482-9. [PMID: 25986958 DOI: 10.1016/j.clbc.2015.04.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Revised: 04/02/2015] [Accepted: 04/16/2015] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Screening programs for breast cancer aim to allow early diagnosis, and thus reduce mortality. The aim of this study was to assess the effect of a population screening program in a sample of women aged between 50 and 69 years in terms of recurrence, metastasis, biological profiles, and survival, and to compare their results with those of women of a wider age range who did not participate on the screening program. PATIENTS AND METHODS A prospective multicenter study in which 1821 patients with 1873 breast tumors who received surgery between 1999 and 2014 at MútuaTerrassa University Hospital and the Hospital of Terrassa in Barcelona were analyzed. A comparison was performed in the 50- to 69-year-old age group between those who participated on the screening program and those who did not. RESULTS The mean age of patients was 58 years. The mean follow-up was 72 months, and median follow-up 59 months. The screened group showed significantly better results in all prognostic factors and in specific mortality than all nonscreened groups. The specific mortality rate in the screened patients was 2.4% (12/496), local recurrence 2.8% (14/496), and metastasis at 10 years 3.6% (18/496). In the nonscreened group, younger women presented a higher rate of metastasis (16.4% [81/493]) and a shorter disease-free period (77.1% [380/493]). The age group older than 70 years had the highest number of T4 tumors (7.5% [30/403]) and the highest proportion of radical surgery (50.4% [203/403]). CONCLUSION Patients in the screening program presented improved survival. We speculate that extending breast cancer screening programs to women younger than 50 and older than 70 years could bring about mortality benefits.
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Affiliation(s)
- Israel Barco
- Department of Gynaecology, Breast Unit, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Barcelona, Spain
| | - Carol Chabrera
- Department of Nursing, School of Health Science Tecnocampus Mataró-Maresme, Barcelona, Spain
| | | | - Nuria Gimenez
- Research Unit, Research Foundation Mútua Terrassa, Universitat de Barcelona, Barcelona, Spain; Laboratory of Toxicology, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Manel Fraile
- Department of Nuclear Medicine (CTD), Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Barcelona, Spain
| | - Josep María Lain
- Breast Unit, Department of Gynaecology, Hospital de Terrassa, Consorci Sanitari de Terrassa, Barcelona, Spain
| | - Merce Piqueras
- Department of Gynaecology, Breast Unit, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Barcelona, Spain
| | - M Carmen Vidal
- Department of Nursing, Breastfeeding Promotion Programme, ASSIR Mollet, Institut Català de la Salut, Barcelona, Spain
| | - Merce Torras
- Department of Nursing, Breast Unit, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Barcelona, Spain
| | - Sonia González
- Department of Oncology, Breast Unit, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Barcelona, Spain
| | - Antoni Pessarrodona
- Department of Gynaecology, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Barcelona, Spain
| | - Josep Barco
- Department of Gynaecology and Obstetrics, Clínica Sant Josep, Manresa, Spain
| | - Jordi Cassadó
- Department of Gynaecology, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Barcelona, Spain
| | - Antonio García Fernández
- Department of Gynaecology, Breast Unit, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Barcelona, Spain; Breast Cancer Screening Unit, Vallès Occidental, Institut Català de la Salut, Terrassa, Barcelona, Spain
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