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• W2885194442 abstract "Purpose: We assessed the effect of breast cancer subtype, as defined by estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) status, on breast cancer survival among young (20-39y), middle-aged (40-49y), screen-aged (50-69y) and elderly (70-89y) women, to elucidate the role of tumor biology for differences in survival across age. Material and methods: A population-based cohort of 21,385 women with a breast cancer diagnosis at ages 20 to 89 between 2005 and 2015 was identified in the Cancer Register of Norway. Subtype was defined as luminal A-like (ER+ PR+ HER2-), luminal B-like HER2-negative (ER+ PR- HER2-), luminal B-like HER2-positive (ER+ PR+/PR- HER2+), HER2-positive (ER- PR- HER2+) and triple-negative (TRN) (ER- PR- HER2-). Cox regression models estimated hazard ratios (HR) for the association between age at diagnosis, subtype and breast cancer specific mortality, while adjusting for year, grade and TNM stage. Results: Young women had higher rates of HER2-positive and TRN tumors compared to middle-aged, screen-aged and elderly women who more often had luminal A-like tumors. Compared to women aged 50-59y, young women had doubled mortality rate (20-39y: HR=2.3 [95% CI 1.8-2.8]), while elderly had two to five times higher mortality rate (70-79y: HR=2.3 [1.9-2.7]; 80-89y: HR=5.2 [4.2-6.4]). After adjustment for subtype, grade and stage the association was reduced among young women (20-39y: HR=1.3 [1.1-1.6]) but less so among the elderly (70-79y: HR=2.1 [1.7-2.5]; 80-89y: HR=3.9 [3.2-4.9]). Among young women, luminal A-like and luminal B-like HER2-negative subtypes were still associated with increased mortality after adjustment for grade and stage. Among the elderly, all subtypes were associated with increased mortality after adjustment for grade and stage, with stronger effects for TRN, HER2-positive and luminal B-like HER2-positive subtypes. Conclusion: Tumor-associated factors, such as subtype, grade and stage, may explain a large part of the poorer survival among young patients, whereas comorbidities and less intensive treatment may explain the persisting poorer survival across subtypes among the elderly. Citation Format: Anna L. Johansson, Cassia B. Trewin, Kirsti V. Hjerkind, Merete Ellingjord-Dale, Tom B. Johannesen, Therese Sorlie, Giske Ursin. Breast cancer survival by age and subtype (ER/PR/HER2) in a nationwide population-based cohort [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 4218." @default.
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• W2885194442 date "2018-07-01" @default.
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• W2885194442 title "Abstract 4218: Breast cancer survival by age and subtype (ER/PR/HER2) in a nationwide population-based cohort" @default.
• W2885194442 doi "https://doi.org/10.1158/1538-7445.am2018-4218" @default.
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