Affiliation:
1. Hakuaikai Sagara Hospital
2. University of Tokyo: Tokyo Daigaku
3. Tokai University: Tokai Daigaku
4. Tohoku University School of Medicine: Tohoku Daigaku Daigakuin Igakukei Kenkyuka Igakubu
5. Kawasaki Medical School: Kawasaki Ika Daigaku
6. Yokkaichi Muncipal Hospital
7. Mitsui Memorial Hospital
8. Hyogo Medical University: Hyogo Ika Daigaku
9. Showa University: Showa Daigaku
10. National Cancer Center Japan: Kokuritsu Gan Kenkyu Center
11. Tokyo Toritsu Komagome Byoin
12. Fukushima Medical University: Fukushima Kenritsu Ika Daigaku
Abstract
Abstract
The Japanese Breast Cancer Society initiated the breast cancer registry in 1975, which transitioned to the National Clinical Database-Breast Cancer Registry in 2012. This annual report presents data from 2020 and analyzes the ten-year mortality rates for those aged 65 and older. We analyzed data from 93,784 breast cancer (BC) cases registered in 2020 and assessed 10-year mortality rates for 36,279 elderly patients diagnosed between 2008 and 2012.
In 2020, 99.4% of BC cases were females with a median age of 61. Most (65%) were diagnosed at early stages (Stage 0 or I). Breast-conserving surgery rates varied with stages: 58.5% at cStage I, 30.8% at cStage II, and 13.1% at cStage III. Sentinel lymph node biopsy was done in 73.6% of cases, followed by radiotherapy in 70% of those post-conserving surgery and chemotherapy in 21.1% post-surgery. Pathology showed that 63.4% had tumors under 2.0 cm, 11.7% had pTis tumors, and 77.3% had no axillary lymph node metastasis. ER positivity was seen in 75.1%, HER2 in 14.3%, and 30% had a Ki67 positivity rate above 30%.
Across all stages and subtypes, there was a trend where the 10-year mortality rates increased for individuals older than 65 years. In Stage I, many deaths were not directly linked to BC and, for those with HER2-type and triple-negative BC, breast cancer-related deaths increased with age. Within Stage II, patients older than 70 years with luminal-type BC often experienced deaths not directly linked to BC, whereas patients below 80 years with HER2-type and triple-negative BC, likely had breast cancer-related deaths. In Stage III, breast cancer-related deaths were more common, particularly in HER2 and triple-negative BC,.
Our prognostic analysis underscores distinct mortality patterns by stage, subtype, and age in elderly BC patients. It highlights the importance of personalized treatment strategies, considering subtype-specific aggressiveness, age-related factors, and comorbidities.
Publisher
Research Square Platform LLC
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