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Title: Age exerts a continuous effect in the outcomes of Asian breast cancer patients treated with breast-conserving therapy
Authors: Wong, F.Y 
Tham, W.Y
Nei, W.L
Lim, C
Miao, H 
Keywords: epidermal growth factor receptor 2
adjuvant radiotherapy
breast cancer
breast reconstruction
cancer mortality
cancer recurrence
cancer staging
cohort analysis
digital breast tomosynthesis
disease free survival
follow up
human tissue
local recurrence free survival
lymph vessel metastasis
major clinical study
observational study
overall survival
retrospective study
sentinel lymph node biopsy
survival rate
treatment duration
triple negative breast cancer
tumor volume
very elderly
Asian continental ancestry group
breast tumor
Kaplan Meier method
middle aged
multimodality cancer therapy
outcome assessment
partial mastectomy
proportional hazards model
statistics and numerical data
triple negative breast cancer
tumor recurrence
young adult
Age Factors
Aged, 80 and over
Asian Continental Ancestry Group
Breast Neoplasms
Combined Modality Therapy
Kaplan-Meier Estimate
Mastectomy, Segmental
Middle Aged
Neoplasm Recurrence, Local
Outcome Assessment (Health Care)
Proportional Hazards Models
Retrospective Studies
Triple Negative Breast Neoplasms
Young Adult
Issue Date: 2018
Citation: Wong, F.Y, Tham, W.Y, Nei, W.L, Lim, C, Miao, H (2018). Age exerts a continuous effect in the outcomes of Asian breast cancer patients treated with breast-conserving therapy. Cancer Communications 38 (1) : 39. ScholarBank@NUS Repository.
Abstract: Background: Asians are diagnosed with breast cancer at a younger age than Caucasians are. We studied the effect of age on locoregional recurrence and the survival of Asian breast cancer patients treated with breast-conserving therapy. Methods: Medical records of 2492 patients treated with breast-conserving therapy between 1989 and 2012 were reviewed. The Kaplan-Meier method was used to estimate locoregional recurrence, breast cancer-free survival, and breast cancer-specific survival rates. These rates were then compared using log-rank tests. Outcomes and age were modeled by Cox proportional hazards. Fractional polynomials were then used to test for non-linear relationships between age and outcomes. Results: Patients ≤ 40 years old were more likely to have locoregional recurrence than were older patients (Hazard ratio [HR] = 2.32, P < 0.001). Locoregional recurrence rates decreased year-on-year by 4% for patients with luminal-type breast cancers, compared with 8% for those with triple-negative cancers. Similarly, breast cancer-free survival rates increased year-on-year by 4% versus 8% for luminal-type and triple-negative cancers, respectively. Breast cancer-specific survival rates increased with age by 5% year-on-year. Both breast cancer-free survival and breast cancer-specific survival rates in patients with luminal cancers exhibited a non-linear ("L-shaped") relationship - where decreasing age at presentation was associated with escalating risks of relapse and death. The influence of age on overall survival was confounded by competing non-cancer deaths in older women, resulting in a "U-shaped" relationship. Conclusions: Young Asian breast cancer patients have a continuous year-on-year increase in rates of disease relapse and cancer deaths compared with older patients with no apparent threshold. © 2018 The Author(s).
Source Title: Cancer Communications
ISSN: 2523-3548
DOI: 10.1186/s40880-018-0310-3
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