Impact of age at diagnosis of metastatic breast cancer on overall survival in the real-life ESME metastatic breast cancer cohort.
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.
['Frank|Sophie|S|', 'Carton|Matthieu|M|', 'Dubot|Coraline|C|', 'Campone|Mario|M|', 'Pistilli|Barbara|B|', 'Dalenc|Florence|F|', 'Mailliez|Audrey|A|', 'Levy|Christelle|C|', "D'Hondt|Véronique|V|", 'Debled|Marc|M|', 'Vermeulin|Thomas|T|', 'Coudert|Bruno|B|', 'Perrin|Christophe|C|', 'Gonçalves|Anthony|A|', 'Uwer|Lionel|L|', 'Ferrero|Jean-Marc|JM|', 'Eymard|Jean-Christophe|JC|', 'Petit|Thierry|T|', 'Mouret-Reynier|Marie-Ange|MA|', 'Patsouris|Anne|A|', 'Guesmia|Tahar|T|', 'Bachelot|Thomas|T|', 'Robain|Mathieu|M|', 'Cottu|Paul|P|']
D000328:Adult D017677:Age Distribution D001943:Breast Neoplasms D015331:Cohort Studies D055088:Early Detection of Cancer D005260:Female D005602:France D006801:Humans D008875:Middle Aged D011379:Prognosis D018719:Receptor, ErbB-2 D012189:Retrospective Studies D016019:Survival Analysis D064726:Triple Negative Breast Neoplasms
Age Breast cancer Overall survival Metastatic disease Real-world data