This preprint is under consideration at BMC Women's Health. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Tumor Characteristics and Treatment Outcomes of Older Patients with Breast Cancer in Jordan
Hikmat Abdel-Razeq
King Hussein Cancer Center
Corresponding Author
ORCiD: https://orcid.org/0000-0003-2833-6051
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Less than 10% of newly diagnosed breast cancer cases in Jordan are diagnosed in women 70 years or older. Treatment plans of such patients is less clear and could result in poor outcomes. In this paper, we describe clinical presentation, tumor characteristics and treatment outcomes in this population of breast cancer patients.
Methods: Consecutive patients aged 65 years or older with pathologically-confirmed diagnosis of breast cancer were included. Medical records and hospital databases were searched for patients’ characteristics and treatment outcomes.
Results: A total of 553 patients, mean age ± SD (71± 5.1) years, were included. On presentation, 114 (20.6%) patients had metastatic disease and was mostly visceral (81; 71.1%). Patients with non-metastatic disease had poor pathological features including node-positive in 244 (55.6%), high grade (grade III) in 170 (38.7%) and lymphovascular invasion in 173 (39.4%). Patients were treated less aggressively; 144 (32.8%) patients with early-stage disease and 98 (86.0%) with metastatic disease never had chemotherapy.
After a median follow up of 45 months, 5-year overall survival for the whole group was 67.6%. Survival was better for patients with non-metastatic disease (78.8% vs. 25.4%, P<0.001) and for those with node-negative compared to node-positive disease (85.4% vs. 74.1%, P=0.002). On Cox regression, only positive lymph nodes were associated with poor outcome in patients with non-metastatic disease (Hazard Ratio [HR], 1.75; 95% CI: 1.006-3.034, P=0.048).
Conclusions: Older Jordanian patients with breast cancer present with more aggressive features and advanced-stage disease that reflect poorly on treatment outcomes. Older patients were treated less aggressively with less than a third received any chemotherapy.
Keywords
Breast cancer; Older women; Jordan; Comorbidities
Figure 1
Figure 2
Figure 3
This is a list of supplementary files associated with this preprint. Click to download.
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 4
Posted 16 Apr, 2020
No community comments so far
Editorial decision: Minor revision
On 19 May, 2020
Editor assigned
On 13 Apr, 2020
Submission checks complete
On 12 Apr, 2020
Editor invited
On 12 Apr, 2020
No comments provided
Editorial decision: Minor revision
On 07 Apr, 2020
Reviewer #2 agreed
On 19 Mar, 2020
Review #2 received
Received 19 Mar, 2020
Review #1 received
Received 18 Mar, 2020
Reviewer #1 agreed
On 08 Mar, 2020
Reviewers invited
Invitations sent on 06 Mar, 2020
Editor assigned
On 20 Feb, 2020
Submission checks complete
On 19 Feb, 2020
Editor invited
On 19 Feb, 2020
No comments provided
Editorial decision: Minor revision
On 18 Feb, 2020
Review #2 received
Received 09 Feb, 2020
Reviewer #2 agreed
On 26 Jan, 2020
Review #1 received
Received 22 Jan, 2020
Reviewer #1 agreed
On 20 Jan, 2020
Reviewers invited
Invitations sent on 17 Jan, 2020
Editor assigned
On 18 Dec, 2019
Submission checks complete
On 17 Dec, 2019
Editor invited
On 17 Dec, 2019
No comments provided
Editorial decision: Major revision
On 13 Dec, 2019
Review #2 received
Received 10 Dec, 2019
Review #3 received
Received 10 Dec, 2019
Reviewer #3 agreed
On 26 Nov, 2019
Review #1 received
Received 20 Nov, 2019
Reviewer #1 agreed
On 18 Nov, 2019
Reviewer #2 agreed
On 18 Nov, 2019
Reviewers invited
Invitations sent on 15 Nov, 2019
Editor assigned
On 09 Nov, 2019
Editor invited
On 04 Nov, 2019
Submission checks complete
On 03 Nov, 2019
First submitted
On 28 Oct, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Learn more about our company.
This preprint is under consideration at BMC Women's Health. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Tumor Characteristics and Treatment Outcomes of Older Patients with Breast Cancer in Jordan
Hikmat Abdel-Razeq
King Hussein Cancer Center
Corresponding Author
ORCiD: https://orcid.org/0000-0003-2833-6051
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 4
Posted 16 Apr, 2020
No community comments so far
Editorial decision: Minor revision
On 19 May, 2020
Editor assigned
On 13 Apr, 2020
Submission checks complete
On 12 Apr, 2020
Editor invited
On 12 Apr, 2020
No comments provided
Editorial decision: Minor revision
On 07 Apr, 2020
Reviewer #2 agreed
On 19 Mar, 2020
Review #2 received
Received 19 Mar, 2020
Review #1 received
Received 18 Mar, 2020
Reviewer #1 agreed
On 08 Mar, 2020
Reviewers invited
Invitations sent on 06 Mar, 2020
Editor assigned
On 20 Feb, 2020
Submission checks complete
On 19 Feb, 2020
Editor invited
On 19 Feb, 2020
No comments provided
Editorial decision: Minor revision
On 18 Feb, 2020
Review #2 received
Received 09 Feb, 2020
Reviewer #2 agreed
On 26 Jan, 2020
Review #1 received
Received 22 Jan, 2020
Reviewer #1 agreed
On 20 Jan, 2020
Reviewers invited
Invitations sent on 17 Jan, 2020
Editor assigned
On 18 Dec, 2019
Submission checks complete
On 17 Dec, 2019
Editor invited
On 17 Dec, 2019
No comments provided
Editorial decision: Major revision
On 13 Dec, 2019
Review #2 received
Received 10 Dec, 2019
Review #3 received
Received 10 Dec, 2019
Reviewer #3 agreed
On 26 Nov, 2019
Review #1 received
Received 20 Nov, 2019
Reviewer #1 agreed
On 18 Nov, 2019
Reviewer #2 agreed
On 18 Nov, 2019
Reviewers invited
Invitations sent on 15 Nov, 2019
Editor assigned
On 09 Nov, 2019
Editor invited
On 04 Nov, 2019
Submission checks complete
On 03 Nov, 2019
First submitted
On 28 Oct, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Less than 10% of newly diagnosed breast cancer cases in Jordan are diagnosed in women 70 years or older. Treatment plans of such patients is less clear and could result in poor outcomes. In this paper, we describe clinical presentation, tumor characteristics and treatment outcomes in this population of breast cancer patients.
Methods: Consecutive patients aged 65 years or older with pathologically-confirmed diagnosis of breast cancer were included. Medical records and hospital databases were searched for patients’ characteristics and treatment outcomes.
Results: A total of 553 patients, mean age ± SD (71± 5.1) years, were included. On presentation, 114 (20.6%) patients had metastatic disease and was mostly visceral (81; 71.1%). Patients with non-metastatic disease had poor pathological features including node-positive in 244 (55.6%), high grade (grade III) in 170 (38.7%) and lymphovascular invasion in 173 (39.4%). Patients were treated less aggressively; 144 (32.8%) patients with early-stage disease and 98 (86.0%) with metastatic disease never had chemotherapy.
After a median follow up of 45 months, 5-year overall survival for the whole group was 67.6%. Survival was better for patients with non-metastatic disease (78.8% vs. 25.4%, P<0.001) and for those with node-negative compared to node-positive disease (85.4% vs. 74.1%, P=0.002). On Cox regression, only positive lymph nodes were associated with poor outcome in patients with non-metastatic disease (Hazard Ratio [HR], 1.75; 95% CI: 1.006-3.034, P=0.048).
Conclusions: Older Jordanian patients with breast cancer present with more aggressive features and advanced-stage disease that reflect poorly on treatment outcomes. Older patients were treated less aggressively with less than a third received any chemotherapy.
Figure 1
Figure 2
Figure 3