Tumor characteristics and treatment outcomes of older patients with breast cancer in Jordan

Abstract Background Less than 10% of newly diagnosed breast cancer cases in Jordan are diagnosed in women 70 years or older. Treatment plans of such patients is less clear and could result in poor outcomes. In this paper, we describe clinical presentation, tumor characteristics and treatment outcome...

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Main Authors: Hikmat Abdel-Razeq, Fadwa Abdel Rahman, Hanan Almasri, Hazem Abdulelah, Mahmoud Abunasser, Mourad Salam, Ayat Taqash
Format: Article
Language:English
Published: BMC 2020-06-01
Series:BMC Women's Health
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12905-020-00981-z
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author Hikmat Abdel-Razeq
Fadwa Abdel Rahman
Hanan Almasri
Hazem Abdulelah
Mahmoud Abunasser
Mourad Salam
Ayat Taqash
author_facet Hikmat Abdel-Razeq
Fadwa Abdel Rahman
Hanan Almasri
Hazem Abdulelah
Mahmoud Abunasser
Mourad Salam
Ayat Taqash
author_sort Hikmat Abdel-Razeq
collection DOAJ
description Abstract Background Less than 10% of newly diagnosed breast cancer cases in Jordan are diagnosed in women 70 years or older. Treatment plans of such patients is less clear and could result in poor outcomes. In this paper, we describe clinical presentation, tumor characteristics and treatment outcomes in this population of breast cancer patients. Methods Consecutive patients aged 65 years or older with pathologically-confirmed diagnosis of breast cancer were included. Medical records and hospital databases were searched for patients’ characteristics and treatment outcomes. Results A total of 553 patients, mean age ± SD (71 ± 5.1) years, were included. On presentation, 114 (20.6%) patients had metastatic disease and was mostly visceral (81; 71.1%). Patients with non-metastatic disease had poor pathological features including node-positive in 244 (55.6%), high grade (grade III) in 170 (38.7%) and lymphovascular invasion in 173 (39.4%). Patients were treated less aggressively; 144 (32.8%) patients with early-stage disease and 98 (86.0%) with metastatic disease never had chemotherapy. After a median follow up of 45 months, 5-year overall survival for the whole group was 67.6%. Survival was better for patients with non-metastatic disease (78.8% vs. 25.4%, P < 0.001) and for those with node-negative compared to node-positive disease (85.4% vs. 74.1%, P = 0.002). On Cox regression, only positive lymph nodes were associated with poor outcome in patients with non-metastatic disease (Hazard Ratio [HR], 1.75; 95% CI: 1.006–3.034, P = 0.048). Conclusions Older Jordanian patients with breast cancer present with more aggressive features and advanced-stage disease that reflect poorly on treatment outcomes. Older patients were treated less aggressively with less than a third received any chemotherapy.
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spelling doaj.art-ec152e4f701347a3b903309631fa1d4a2022-12-22T01:24:08ZengBMCBMC Women's Health1472-68742020-06-012011710.1186/s12905-020-00981-zTumor characteristics and treatment outcomes of older patients with breast cancer in JordanHikmat Abdel-Razeq0Fadwa Abdel Rahman1Hanan Almasri2Hazem Abdulelah3Mahmoud Abunasser4Mourad Salam5Ayat Taqash6Department of Internal Medicine, King Hussein Cancer CenterDepartment of Radiation Oncology, King Hussein Cancer CenterDepartment of Radiation Oncology, King Hussein Cancer CenterDepartment of Internal Medicine, King Hussein Cancer CenterDepartment of Internal Medicine, King Hussein Cancer CenterDepartment of Internal Medicine, King Hussein Cancer CenterOffice of Scientific Affairs and ResearchAbstract Background Less than 10% of newly diagnosed breast cancer cases in Jordan are diagnosed in women 70 years or older. Treatment plans of such patients is less clear and could result in poor outcomes. In this paper, we describe clinical presentation, tumor characteristics and treatment outcomes in this population of breast cancer patients. Methods Consecutive patients aged 65 years or older with pathologically-confirmed diagnosis of breast cancer were included. Medical records and hospital databases were searched for patients’ characteristics and treatment outcomes. Results A total of 553 patients, mean age ± SD (71 ± 5.1) years, were included. On presentation, 114 (20.6%) patients had metastatic disease and was mostly visceral (81; 71.1%). Patients with non-metastatic disease had poor pathological features including node-positive in 244 (55.6%), high grade (grade III) in 170 (38.7%) and lymphovascular invasion in 173 (39.4%). Patients were treated less aggressively; 144 (32.8%) patients with early-stage disease and 98 (86.0%) with metastatic disease never had chemotherapy. After a median follow up of 45 months, 5-year overall survival for the whole group was 67.6%. Survival was better for patients with non-metastatic disease (78.8% vs. 25.4%, P < 0.001) and for those with node-negative compared to node-positive disease (85.4% vs. 74.1%, P = 0.002). On Cox regression, only positive lymph nodes were associated with poor outcome in patients with non-metastatic disease (Hazard Ratio [HR], 1.75; 95% CI: 1.006–3.034, P = 0.048). Conclusions Older Jordanian patients with breast cancer present with more aggressive features and advanced-stage disease that reflect poorly on treatment outcomes. Older patients were treated less aggressively with less than a third received any chemotherapy.http://link.springer.com/article/10.1186/s12905-020-00981-zBreast cancerOlder womenJordanComorbidities
spellingShingle Hikmat Abdel-Razeq
Fadwa Abdel Rahman
Hanan Almasri
Hazem Abdulelah
Mahmoud Abunasser
Mourad Salam
Ayat Taqash
Tumor characteristics and treatment outcomes of older patients with breast cancer in Jordan
BMC Women's Health
Breast cancer
Older women
Jordan
Comorbidities
title Tumor characteristics and treatment outcomes of older patients with breast cancer in Jordan
title_full Tumor characteristics and treatment outcomes of older patients with breast cancer in Jordan
title_fullStr Tumor characteristics and treatment outcomes of older patients with breast cancer in Jordan
title_full_unstemmed Tumor characteristics and treatment outcomes of older patients with breast cancer in Jordan
title_short Tumor characteristics and treatment outcomes of older patients with breast cancer in Jordan
title_sort tumor characteristics and treatment outcomes of older patients with breast cancer in jordan
topic Breast cancer
Older women
Jordan
Comorbidities
url http://link.springer.com/article/10.1186/s12905-020-00981-z
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AT hazemabdulelah tumorcharacteristicsandtreatmentoutcomesofolderpatientswithbreastcancerinjordan
AT mahmoudabunasser tumorcharacteristicsandtreatmentoutcomesofolderpatientswithbreastcancerinjordan
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