Clinico-Epidemiological Study of Elderly Breast Cancer in a Developing Country: Egypt

Noha Yehia Ibrahim; Soha Talima; Wael Samir Makar

doi:doi:10.11648/j.jctr.20190701.14

| Peer-Reviewed

Clinico-Epidemiological Study of Elderly Breast Cancer in a Developing Country: Egypt

Noha Yehia Ibrahim, Soha Talima, Wael Samir Makar

Published in Journal of Cancer Treatment and Research (Volume 7, Issue 1)

Received: 11 March 2019 Accepted: 26 April 2019 Published: 30 May 2019

Views: Downloads:

Download PDF

Share This Article

Twitter
Linked In
Facebook

Abstract

Context: The prognosis and treatment outcome in elderly breast cancer is not well known. Aim: To study the prognosis and treatment outcome in elderly breast cancer. Methods and materials: This a retrospective study of breast cancer patients’ ≥70years in the period from January 2005 until December 2010 in Egypt. Kaplan Meir overall survival (OS) analysis and disease-free survival (DFS) were done and they were correlated with different prognostic factors. Results: Among 186 old patients, 139 one were analyzed. The median age was 73.4 years at diagnosis with a mean of 75. Most patients (70.4%) were in the range of 70-74 from urban areas (89.2%) with performance status 1-2 (90.6%) and with ≤ 2 co-morbidity (67.6%). Stage III and IV presented 43.9%. Positive ER and PR was 83.4% and 75.5% respectively. Surgery was done in 77.7% of cases with 62.6% modified radical mastectomy and 15.1% conservative lumpectomy and axillary clearance. Treatment included mostly hormonal treatment (79.9%), radiotherapy (47.5%) and lastly chemotherapy (18.7%). The 5-year OS and DFS were 52% and 53.4% respectively. The median progression free survival (PFS) in metastatic patients was 4 months. The DFS was significantly affected by performance status (PS), tumor stage, and presence of metastasis. (P-value = 0.018, <0.001, 0.003 respectively). Conclusion: the 5-year OS was lower than the developed country. The majority of deaths (55.7%) were not related to breast cancer. Primary tumor stage and metastasis were significant prognostic factor for DFS.

Published in	Journal of Cancer Treatment and Research (Volume 7, Issue 1)
DOI	10.11648/j.jctr.20190701.14
Page(s)	23-27
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Breast Cancer, Egypt, Elderly, Epidemiology, Survival

References

[1]	Ibrahim AS, Khaled H M, Mikhail N NH, Baraka H, Kamel H. Cancer Incidence in Egypt: Results of the National Population-Based Cancer Registry Program. Journal of Cancer Epidemiology 2014. Article ID 437971, 18 pages. http://dx.doi.org/10.1155/2014/437971.
[2]	Bray F, Ferlay J, Soerjomataram I, Siegel R, Torre L et al. Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. Cancer Journal for Clinicians, 2018; VOLUME 68, NUMBER 6,\| NOVEMBER/DECEMBER
[3]	Hirko KA, Soliman AS, Hablas A, Ibrahim A. Seifeldin IA, Ramadan M et al., Trends in Breast Cancer Incidence Rates by Age and Stage at Diagnosis in Gharbiah, Egypt, over 10 Years (1999–2008). Journal of Cancer Epidemiology 2013. Article ID 916394, 7 pages.
[4]	The Egyptian Central Agency for Public Mobilization and Statistics. People [online], ; 2012 [accessed 26.09.2012].
[5]	http://www.indexmundi.com/egypt/demographics_profile.html, search for The Egyptian Central Agency for Public Mobilization and mobilization
[6]	Diab SG, Elledge RM, Clark GM. Tumor characteristics and clinical outcome of elderly women with breast cancer. J Natl Cancer Inst 2000; 92:550-6.
[7]	Rocco N, Rispoli C, Pango G, et al. Undertreatment of breast cancer in the elderly. BMC Surg 2013; 13(suppl. 2) S26-2482-13-S2-S26. Epub 2013 oct 8.)
[8]	Office for National Statistics. Cancer survival in England: adults diagnosed in 2009 to 2013, followed up to 2014. Newport: ONS; 2015
[9]	Phua CE, Bustam AZ, Cheng-Har Yip, Nor Aishah Taib. Prognostic Factors for Elderly Breast Cancer Patients in University Malaya Medical Centre, Malaysia. Asian Pacific Journal of Cancer Prevention 2010; Vol 11, 1205-1211.
[10]	Austin A. M, Hill A. G, and Fawzi W. W. Maternal obesity trends in Egypt 1995–2005. Maternal & Child Nutrition 2013; Vol. 9, no. 2, pp. 167–179.
[11]	Kartal M, Tezcan S and Canda T. Diagnosis, treatment characteristics, and survival of women with breast cancer aged 65 and above: a hospital-based retrospective study. BioMed Central. BMC Women's Health 2013, 13:34
[12]	Office for National Statistics. (2013). Statistical Bulletin: Cancer survival in England: Patient diagnosed 2007-2011and followed up to 2012. Newport: ONS; 2013.
[13]	Brandt J. Garne JP, Tengrup I and Manje J. Age at diagnosis in relation to survival following breast cancer: a cohort study. World Journal of Surgical Oncology 2015; 13:33.
[14]	Hancke K, Denkinger MD, König JKurzeder C, Wöckel A, Herr D, Blettner M, Kreienberg R. Standard treatment of female patients with breast cancer decreases substantially for women aged 70 years and older: a German clinical cohort study. Ann Oncol 2010; 21(Suppl 4):748–753.
[15]	Daidone MG, Coradini D, Martelli G, et al. Primary breast cancer in elderly women: biological profile and relation with clinical outcome. Critical Rev Oncol/Haematol, 2003, 45, 13-325.
[16]	Syed BM, Green AR, Paish EC, et al. Biology of primary breast cancer in older women treated by surgery: with correlation with long-term clinical outcome and comparison with their younger counterparts. Br J Cancer. 2013; 108(5):1042-51.
[17]	Cappellani A, Di Vita M, Zanghì A, Cavallaro A, Piccolo G, Majorana M, Barbera G, Berretta M. Prognostic factors in elderly patients with breast Cancer. From 26th National Congress of the Italian Society of Geriatric Surgery. Naples, Italy. 19-22 June 2013. BMC Surgery 2013, 13(Suppl 2):S2
[18]	Takuwa H, Tsuji W, Yotsumoto F. Overall survival of elderly patients with breast cancer is not related to breast-cancer specific survival: A single institution experience in Japan. Breast Dis. 2018 Apr 5. doi: 10.3233/BD-170280.
[19]	Park JH, Choi IS, Kim KH, et al. Treatment Patterns and Outcomes in Elderly Patients with Metastatic Breast Cancer: A Multicenter Retrospective Study. J Breast Cancer. 2017; 20(4):368-377.
[20]	"World Health Statistics (2016). Monitoring health for the SDGs Annex B: tables of health statistics by country, WHO region and globally". World Health Organization. 2016. Retrieved 27 June 2016.

Cite This Article

Plain Text BibTeX RIS

APA Style

Noha Yehia Ibrahim, Soha Talima, Wael Samir Makar. (2019). Clinico-Epidemiological Study of Elderly Breast Cancer in a Developing Country: Egypt. Journal of Cancer Treatment and Research, 7(1), 23-27. https://doi.org/10.11648/j.jctr.20190701.14

Copy | Download

ACS Style

Noha Yehia Ibrahim; Soha Talima; Wael Samir Makar. Clinico-Epidemiological Study of Elderly Breast Cancer in a Developing Country: Egypt. J. Cancer Treat. Res. 2019, 7(1), 23-27. doi: 10.11648/j.jctr.20190701.14

Copy | Download

AMA Style

Noha Yehia Ibrahim, Soha Talima, Wael Samir Makar. Clinico-Epidemiological Study of Elderly Breast Cancer in a Developing Country: Egypt. J Cancer Treat Res. 2019;7(1):23-27. doi: 10.11648/j.jctr.20190701.14

Copy | Download

@article{10.11648/j.jctr.20190701.14,
  author = {Noha Yehia Ibrahim and Soha Talima and Wael Samir Makar},
  title = {Clinico-Epidemiological Study of Elderly Breast Cancer in a Developing Country: Egypt},
  journal = {Journal of Cancer Treatment and Research},
  volume = {7},
  number = {1},
  pages = {23-27},
  doi = {10.11648/j.jctr.20190701.14},
  url = {https://doi.org/10.11648/j.jctr.20190701.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jctr.20190701.14},
  abstract = {Context: The prognosis and treatment outcome in elderly breast cancer is not well known. Aim: To study the prognosis and treatment outcome in elderly breast cancer. Methods and materials: This a retrospective study of breast cancer patients’ ≥70years in the period from January 2005 until December 2010 in Egypt. Kaplan Meir overall survival (OS) analysis and disease-free survival (DFS) were done and they were correlated with different prognostic factors. Results: Among 186 old patients, 139 one were analyzed. The median age was 73.4 years at diagnosis with a mean of 75. Most patients (70.4%) were in the range of 70-74 from urban areas (89.2%) with performance status 1-2 (90.6%) and with ≤ 2 co-morbidity (67.6%). Stage III and IV presented 43.9%. Positive ER and PR was 83.4% and 75.5% respectively. Surgery was done in 77.7% of cases with 62.6% modified radical mastectomy and 15.1% conservative lumpectomy and axillary clearance. Treatment included mostly hormonal treatment (79.9%), radiotherapy (47.5%) and lastly chemotherapy (18.7%). The 5-year OS and DFS were 52% and 53.4% respectively. The median progression free survival (PFS) in metastatic patients was 4 months. The DFS was significantly affected by performance status (PS), tumor stage, and presence of metastasis. (P-value = 0.018, Conclusion: the 5-year OS was lower than the developed country. The majority of deaths (55.7%) were not related to breast cancer. Primary tumor stage and metastasis were significant prognostic factor for DFS.},
 year = {2019}
}

Copy | Download

TY - JOUR
T1 - Clinico-Epidemiological Study of Elderly Breast Cancer in a Developing Country: Egypt
AU - Noha Yehia Ibrahim
AU - Soha Talima
AU - Wael Samir Makar
Y1 - 2019/05/30
PY - 2019
N1 - https://doi.org/10.11648/j.jctr.20190701.14
DO - 10.11648/j.jctr.20190701.14
T2 - Journal of Cancer Treatment and Research
JF - Journal of Cancer Treatment and Research
JO - Journal of Cancer Treatment and Research
SP - 23
EP - 27
PB - Science Publishing Group
SN - 2376-7790
UR - https://doi.org/10.11648/j.jctr.20190701.14
AB - Context: The prognosis and treatment outcome in elderly breast cancer is not well known. Aim: To study the prognosis and treatment outcome in elderly breast cancer. Methods and materials: This a retrospective study of breast cancer patients’ ≥70years in the period from January 2005 until December 2010 in Egypt. Kaplan Meir overall survival (OS) analysis and disease-free survival (DFS) were done and they were correlated with different prognostic factors. Results: Among 186 old patients, 139 one were analyzed. The median age was 73.4 years at diagnosis with a mean of 75. Most patients (70.4%) were in the range of 70-74 from urban areas (89.2%) with performance status 1-2 (90.6%) and with ≤ 2 co-morbidity (67.6%). Stage III and IV presented 43.9%. Positive ER and PR was 83.4% and 75.5% respectively. Surgery was done in 77.7% of cases with 62.6% modified radical mastectomy and 15.1% conservative lumpectomy and axillary clearance. Treatment included mostly hormonal treatment (79.9%), radiotherapy (47.5%) and lastly chemotherapy (18.7%). The 5-year OS and DFS were 52% and 53.4% respectively. The median progression free survival (PFS) in metastatic patients was 4 months. The DFS was significantly affected by performance status (PS), tumor stage, and presence of metastasis. (P-value = 0.018, Conclusion: the 5-year OS was lower than the developed country. The majority of deaths (55.7%) were not related to breast cancer. Primary tumor stage and metastasis were significant prognostic factor for DFS.
VL - 7
IS - 1
ER -

Copy | Download

Author Information

Noha Yehia Ibrahim

Clinical Oncology Department (NEMROCK), Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt
Soha Talima

Clinical Oncology Department (NEMROCK), Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt
Wael Samir Makar

Clinical Oncology Department (NEMROCK), Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt

Download PDF

Sections

Plain Text BibTeX RIS

APA Style

Noha Yehia Ibrahim, Soha Talima, Wael Samir Makar. (2019). Clinico-Epidemiological Study of Elderly Breast Cancer in a Developing Country: Egypt. Journal of Cancer Treatment and Research, 7(1), 23-27. https://doi.org/10.11648/j.jctr.20190701.14

Copy | Download

ACS Style

Noha Yehia Ibrahim; Soha Talima; Wael Samir Makar. Clinico-Epidemiological Study of Elderly Breast Cancer in a Developing Country: Egypt. J. Cancer Treat. Res. 2019, 7(1), 23-27. doi: 10.11648/j.jctr.20190701.14

Copy | Download

AMA Style

Noha Yehia Ibrahim, Soha Talima, Wael Samir Makar. Clinico-Epidemiological Study of Elderly Breast Cancer in a Developing Country: Egypt. J Cancer Treat Res. 2019;7(1):23-27. doi: 10.11648/j.jctr.20190701.14

Copy | Download

@article{10.11648/j.jctr.20190701.14,
  author = {Noha Yehia Ibrahim and Soha Talima and Wael Samir Makar},
  title = {Clinico-Epidemiological Study of Elderly Breast Cancer in a Developing Country: Egypt},
  journal = {Journal of Cancer Treatment and Research},
  volume = {7},
  number = {1},
  pages = {23-27},
  doi = {10.11648/j.jctr.20190701.14},
  url = {https://doi.org/10.11648/j.jctr.20190701.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jctr.20190701.14},
  abstract = {Context: The prognosis and treatment outcome in elderly breast cancer is not well known. Aim: To study the prognosis and treatment outcome in elderly breast cancer. Methods and materials: This a retrospective study of breast cancer patients’ ≥70years in the period from January 2005 until December 2010 in Egypt. Kaplan Meir overall survival (OS) analysis and disease-free survival (DFS) were done and they were correlated with different prognostic factors. Results: Among 186 old patients, 139 one were analyzed. The median age was 73.4 years at diagnosis with a mean of 75. Most patients (70.4%) were in the range of 70-74 from urban areas (89.2%) with performance status 1-2 (90.6%) and with ≤ 2 co-morbidity (67.6%). Stage III and IV presented 43.9%. Positive ER and PR was 83.4% and 75.5% respectively. Surgery was done in 77.7% of cases with 62.6% modified radical mastectomy and 15.1% conservative lumpectomy and axillary clearance. Treatment included mostly hormonal treatment (79.9%), radiotherapy (47.5%) and lastly chemotherapy (18.7%). The 5-year OS and DFS were 52% and 53.4% respectively. The median progression free survival (PFS) in metastatic patients was 4 months. The DFS was significantly affected by performance status (PS), tumor stage, and presence of metastasis. (P-value = 0.018, Conclusion: the 5-year OS was lower than the developed country. The majority of deaths (55.7%) were not related to breast cancer. Primary tumor stage and metastasis were significant prognostic factor for DFS.},
 year = {2019}
}

Copy | Download