Modeling the effect of age in T1-2 breast cancer using the SEER database.

Abstract:

BACKGROUND:Modeling the relationship between age and mortality for breast cancer patients may have important prognostic and therapeutic implications. METHODS:Data from 9 registries of the Surveillance, Epidemiology, and End Results Program (SEER) of the United States were used. This study employed proportional hazards to model mortality in women with T1-2 breast cancers. The residuals of the model were used to examine the effect of age on mortality. This procedure was applied to node-negative (N0) and node-positive (N+) patients. All causes mortality and breast cancer specific mortality were evaluated. RESULTS:The relationship between age and mortality is biphasic. For both N0 and N+ patients among the T1-2 group, the analysis suggested two age components. One component is linear and corresponds to a natural increase of mortality with each year of age. The other component is quasi-quadratic and is centered around age 50. This component contributes to an increased risk of mortality as age increases beyond 50. It suggests a hormonally related process: the farther from menopause in either direction, the more prognosis is adversely influenced by the quasi-quadratic component. There is a complex relationship between hormone receptor status and other prognostic factors, like age. CONCLUSION:The present analysis confirms the findings of many epidemiological and clinical trials that the relationship between age and mortality is biphasic. Compared with older patients, young women experience an abnormally high risk of death. Among elderly patients, the risk of death from breast cancer does not decrease with increasing age. These facts are important in the discussion of options for adjuvant treatment with breast cancer patients.

journal_name

BMC Cancer

journal_title

BMC cancer

authors

Tai P,Cserni G,Van De Steene J,Vlastos G,Voordeckers M,Royce M,Lee SJ,Vinh-Hung V,Storme G

doi

10.1186/1471-2407-5-130

keywords:

subject

Has Abstract

pub_date

2005-10-08 00:00:00

pages

130

issn

1471-2407

pii

1471-2407-5-130

journal_volume

5

pub_type

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