Aug 2026· Current Oncology· 0 citations· 54 references
TL;DR
In a sample of women with Stage I-III breast cancer who received chemotherapy with curative intent, triple negative subtype, smoking history, tumor size, and surgery type were significantly associated with shorter five-year event free survival.
Abstract
Background: Age, race, body mass index (BMI), breast density, parity, smoking and alcohol use are associated with increased risk for breast cancer. These factors, as well as tumor characteristics, treatment regimens and comorbidities, are analyzed for associations with five-year event free survival (EFS) in a sample of women with Stage I-III breast cancer who received chemotherapy with curative intent. Methods: EFS was defined in terms of breast cancer recurrence, second primary, metastasis, and overall survival. Analyses were stratified by age (under age 65 vs. over age 65). EFS was estimated using the Kaplan–Meier method and compared using a Cox proportional hazard model. Results: In a sample of 821 women, mean age at diagnosis was 54 years, with 75% White and 22% Black. Younger women had higher proportions of Stage II and III tumors (p = 0.005), larger tumor size (p = 0.0004), and higher breast density (p = 0.003). Five-year EFS was 91% among younger vs. 82% among older women (p = 0.0005). In women aged < 65, there were 48 EFS events, and triple negative patients had significantly worse EFS compared to other subtypes (p = 0.003). Smokers also had worse EFS (p = 0.04). In women aged ≥ 65, there were 26 events, and both tumor size (p = 0.02) and mastectomy (p = 0.03) were significant for EFS. Conclusions: In our sample, triple negative subtype, smoking history, tumor size, and surgery type were significantly associated with shorter EFS. Race, BMI, alcohol use, parity, breast density, radiation treatment, and specific chemotherapy regimen were not significant for EFS in either age group.
Background Breast cancer (BC) mortality risk extends over decades; yet, the temporal prognostic patterns of histological grade across subtypes and stages remain unclear. Patients and methods Women with stage I-III BC diagnosed between 2000 and 2018 were identified from Surveillance, Epidemiology, and End Results registries (N = 767 218). Breast cancer-specific mortality (BCSM), as the primary endpoint, was analyzed using cumulative incidence functions including competing risk and annual hazard rates stratified by grade, estrogen receptor (ER) status, stage, and adjuvant chemotherapy. Restricted mean survival time differences were calculated to quantify absolute survival differences across follow-up intervals. Landmark survival analyses were carried out for 0 to <60, 60 to <120, and 120 to <180 months from diagnosis. Time-varying effects of grade were assessed through interval-specific modeling to evaluate nonproportional hazards. Results Overall, 23%, 44%, and 33% of cancers were grades 1, 2, and 3, respectively, accounting for 8%, 35%, and 57% of BC deaths. In each consecutive follow-up period, the contribution of grade 1 cancers to BCSM increased, and the contribution of grade 3 cancers decreased. Overall, 59% and 30% of deaths from grades 1 and 3 cancers, respectively, occurred after 5 years. In ER-positive disease, grade 3 tumors showed peak annual hazards between years 3 and 5, whereas grade 1 tumors had lower but sustained hazards extending beyond 10 years; the hazard curves converged between years 10 and 12. In ER-negative disease, early hazards were higher, and convergence also started earlier at years 5-8. Absolute risk was influenced by nodal status and tumor stage within each grade category and follow-up interval. Conclusion Grade 1 cancers show sustained risk beyond 10 years, whereas grade 3 cancers exhibit front-loaded risk. These temporal risk patterns, together with other clinical and genomic data, could inform extended endocrine therapy decisions and surveillance strategies.
M. Mariani, M. Ochocki, G. Bianchini et al.· ESMO Open· 0 citations
Obesity is a major health concern; research has linked obesity to increased breast cancer risk and poor survival outcome in postmenopausal women with hormone receptor–positive disease. Suggesting that adiposity may reduce the therapeutic efficacy of endocrine therapies, leading to higher risks of recurrence.
To examine the association of body mass index (BMI) with recurrence and survival.
This retrospective study enrolled 76 postmenopausal women diagnosed with stage I to III hormone receptor-positive breast cancer treated with aromatase inhibitors, attending the Clinical Oncology Department of Ain Shams University hospitals during the period from January 2016 to December 2022. Kaplan–Meier curves were used to perform survival analysis.
Patients with BMI <34 had slightly higher 5-year DFS (85.4% vs. 82.8%; p = 0.586) and DMFS (88.3% vs. 84.9%; p = 0.869) compared to those with BMI >34. Across obesity classes, 5-year DFS ranged from 73.3% in Class III to 90.9% in Class II, with DMFS rates of 77.4% and 90.9%; none were statistically significant.
BMI did not significantly influence survival outcomes in postmenopausal women with hormone receptor-positive breast cancer treated with aromatase inhibitors. Although survival tended to be lower with higher BMI, it was not statistically significant.
Noha Eslam Attia Sakr, H. Abdulla, Ahmed Gaballa et al.· The Quarterly journal of med...· 0 citations
OBJECTIVE
Breast cancer method of detection (MOD) describes how a cancer is first identified: through screening or non-screening (symptomatic/incidental) presentation. We examined associations between MOD and patient demographics, tumor characteristics, treatment patterns, and survival.
METHODS
This retrospective cohort study included women ≥40 years diagnosed with breast cancer between 1/2019 and 12/2021, follow-up through 7/2026. MOD was classified as screen-detected or non-screen-detected. Logistic regression and chi-square tests evaluated associations with patient, tumor, and treatment variables. Kaplan-Meier and multivariable Cox regression assessed all-cause survival.
RESULTS
Among 1,023 women (mean age 63.5 ± 12.1 years), screen-detected cancers (n=710, 69.4%) had more favorable characteristics: earlier T stage (T0: 26.3% vs. 5.4%, p<0.001), negative lymph nodes (N0: 85.5% vs. 59.1%, p<0.001), fewer metastases (M0: 98.6% vs. 82.4%, p<0.001), and lower grade (grade 1: 18.6% vs. 7.4%, p<0.001). More received lumpectomy (72.1% vs. 50.2%, p<0.001) and fewer received neoadjuvant chemotherapy (5.2% vs. 22.5%, p<0.001). Non-screen-detected cancers were more common among the unemployed (21.0% vs. 14.0%, p=0.001), uninsured (3.8% vs. 1.7%, p=0.026), and women ≥75 years (23.3% vs. 16.1%, p=0.019). Within non-screen-detected cancers, tumor stage worsened with time since last negative screen (p<0.001). Screen-detected cancers showed superior all-cause survival (5-year: 92.9% vs. 73.6%, p<0.001). After adjustment, screen-detection was independently associated with 43% lower mortality (HR=0.57, p=0.003). Significant survival benefit persisted in women ≥75 years (HR=0.44, p=0.014).
DISCUSSION
Screen-detected breast cancers were associated with favorable biology, less aggressive treatment, and improved survival. These findings can inform screening guidelines and underscore the importance of incorporating MOD into cancer registries.
Babita Panigrahi, Alexandra DiTommaso, N. Ghuman et al.· Journal of the American Coll...· 0 citations
BACKGROUND
Stage at diagnosis, histologic grade, and molecular subtypes are established prognostic indicators for women with breast cancer (BC), but their impact on population-based survival estimates is poorly documented. This study assessed long-term BC survival trends according to these factors.
METHODS
We identified women aged <75 years diagnosed with stage I-IV invasive BC between 2004 and 2014 from the Friuli Venezia Giulia (North Eastern Italy) Cancer Registry (N = 10,476). Follow-up through 2023 was used to estimate overall and net survival (NS) according to combinations of prognostic factors.
RESULTS
The highest 10-year NS (10-NS) was observed in women with stage I HR+/HER2- subtype (98.8%), while it was 35.1% for stage III triple-negative (TN) subtype. Among women with stage IV BC, 10-NS was 18.9% for those HR-/HER2+, 11.5% for those HR+/HER2+, 8.3% for HR+/HER2-, and 6.7% for TN. For each stage, NS decreased with increasing grade. Comparing period of diagnosis (2004-2009 vs 2010-2014), 10-NS remained >90% for women with stage I BC, but improved for stage III and aggressive subtypes (HR-/HER2+ and TN). In women with stage III HR-/HER2+ BC, 10-NS increased from 48.6% to 87.9% (+39 percentage points), while when diagnosis was stage III TN BC it rose from 28.8% to 42.3.
CONCLUSION
Population-based estimates of long-term BC survival by combined stage, grade, and molecular subtype can inform the interpretation of evolving therapeutic strategies and improve risk stratification for patient follow-up.
Fabiola Giudici, D. Serraino, F. Puglisi et al.· The Oncologist· 0 citations
This study explores the role of clinical factors in influencing relapse-free survival (RFS) in breast cancer patients through comprehensive survival analysis (SA). The data were derived from a large cohort of breast cancer patients, encompassing clinical variables such as age at diagnosis, tumor size, number of positive lymph nodes, tumor grade, histological subtype, and receipt of chemotherapy and radiotherapy. Analytical methods included Kaplan-Meier plots, log-rank tests, Cox proportional hazards modeling, and feature ranking based on univariate and multivariate log-rank and Cox tests. The results show that patients who received chemotherapy demonstrated a shorter median RFS compared to those who did not (102.7 vs. 145.0 months, p = 0.03), likely due to high-risk patients being selected for chemotherapy. Meanwhile, radiotherapy was associated with improved prognosis (hazard ratio (HR) < 1 in Cox model, p < 10−5), in line with meta-analyses showing reduced breast cancer mortality post-radiotherapy. The contribution maps the key clinical determinants of RFS in breast cancer and highlights the practicality of performing SA.
Boby Al Qurthuby, I. M. Murwantara· International Journal of Adv...· 0 citations
Triple-negative breast cancer (TNBC) is characterized by aggressive biological behavior and poor prognosis. While multimodal treatment is standard, it is frequently withheld from older adults. We evaluated age-related gaps in diagnosis, treatment, and survival, testing whether disparities in clinical management drive worse outcomes in older adults. This 10-year retrospective cohort study (2010–2019) included 289 TNBC patients stratified into three age groups (≤ 45, 46–69 and ≥ 70 years). Clinicopathological features, treatment patterns, adherence to the ESMO-defined standard of care (SOC), and 5-year survival were analyzed. TNBC incidence (10.8%) remained consistent across age groups (
p =
0.374). Patients aged ≥ 70 years presented with larger tumors (median: 27 mm;
p =
0.003) and received less intensive diagnostic workups (
p <
0.001). SOC adherence was significantly lower in older adults (50.9% vs. 85.9% in those ≤ 45 years;
p <
0.001). SOC nonadherence increased the risk for both overall mortality (OM) (HR: 3.47) and breast cancer-specific mortality (BCSM) (sHR: 2.88) (
p <
0.001). Failure to achieve pathologic complete response (pCR) tripled mortality risk (OM HR: 3.74,
p
= 0.016; BCSM sHR: 3.54,
p
= 0.018). Older women had lower survival rates than did those aged 46–69 years for both 5-year overall (56.0% vs. 83.0%;
p <
0.001) and breast cancer-specific survival (63.0% vs. 85.0%;
p =
0.006). The poorer prognosis in older adults with TNBC is significantly associated with clinical management disparities and low SOC adherence, while histopathological markers of tumor aggressiveness remain highly prevalent across the age spectrum. Daily practice must transition from chronological age-based decisions toward biological fitness to overcome ageism, avoid undertreatment, and ensure personalized therapeutic decision-making.
Dinis Galhardo, B. Peleteiro, Fernando Osório· Aging Clinical and Experimen...· 0 citations
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