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Impact of age at diagnosis of metastatic breast cancer on overall survival in the real-life ESME metastatic breast cancer cohort

Sophie Frank 1 Matthieu Carton 1 Coraline Dubot 1 Mario Campone 2, 3 Barbara Pistilli 4 Florence Dalenc 5 Audrey Mailliez 6 Christelle Lévy 7 Veronique d'Hondt 8 Marc Debled 9 Thomas Vermeulin 10 Benoit Coudert 11 Christophe Perrin 12 Anthony Gonçalves 13 Lionel Uwer 14 Jean-Marc Ferrero 15 Jean-Christophe Eymard 16 Thierry Petit 17 Marie-Ange Mouret-Reynier 18 Anne Patsouris 2 Tahar Guesmia 19, 20 Thomas Bachelot 21 Mathieu Robain 19, 20 Paul Cottu 1 
Abstract : Background: Young age is a poor prognostic factor in early stage breast cancer (BC) but its value is less established in metastatic BC (MBC). We evaluated the impact of age at MBC diagnosis on overall survival (OS) across three age groups (<40, 40 to 60 and > 60 years(y)). Methods: ESME MBC database is a national cohort, collecting retrospective data from 18 participating French cancer centers between January 01, 2008 and December 31, 2014. Results: Among 14 403 women included, 1077 (7.5%), 6436 (44.7%) and 6890 (47.8%) pts were <40, 40-60 and > 60 y respectively. Pts <40 had significantly more aggressive presentations than other age groups: more frequent HER2+ (25.7 vs 15.3% in >60y) and triple negative subtypes (27.4 vs 14.6% in >60y), and more frequent visceral involvement (36.3 vs 29.8% in >60y). At a median follow-up of 48 months, median OS differed across age groups: 38.8, 38.4 and 35.6 months for pts <40, 40-60 and > 60y, respectively (p < 0.0001). Compared to pts <40y, older pts had a statistically significant higher risk of death (all causes of death included), although of limited clinical value (HR = 1.1, IC 95%:1.01-1.20). There was a significant trend for better OS in pts <40y with HER2+ and luminal diseases. A possible explanation is a greater use of anti-Her2 therapies as first-line treatments: 86.6, 81.9 and 74.9% for pts <40, 40-60 and > 60y, respectively (p < 0.0001). Conclusion: Although young age seems associated with more aggressive presentations at diagnosis of MBC, it has no deleterious effect on OS in this large series.
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https://hal.archives-ouvertes.fr/hal-02888009
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Sophie Frank, Matthieu Carton, Coraline Dubot, Mario Campone, Barbara Pistilli, et al.. Impact of age at diagnosis of metastatic breast cancer on overall survival in the real-life ESME metastatic breast cancer cohort. Breast, Elsevier, 2020, 52, pp.50-57. ⟨10.1016/j.breast.2020.04.009⟩. ⟨hal-02888009v1⟩

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