Older Breast Cancer Patients Defy Survival Models

“Older women with early-stage, invasive breast cancer had better survival rates than what was estimated by a popular online tool for predicting survival, according to researchers at the Duke Cancer Institute.

“The finding provides a stronger rationale for women over the age of 70 — even those who have additional minor health concerns — to undergo aggressive treatments such as chemotherapy to prevent their cancer from returning.

“ ‘When making decisions about whether or not to use potentially toxic preventive chemotherapy for breast cancer in older women, patients and doctors debate what they should do,’ said Gretchen Kimmick, M.D., M.S., an associate professor of medicine at Duke who is presenting the study findings at the San Antonio Breast Cancer Symposium. ‘This predictive model can help us show patients that they are going to survive long enough to see the benefit of treatment.’ “


Death Rates from Invasive Breast Cancer Fall

“From 1973 to 2010 in the U.S., large reductions in breast cancer-specific death hazards were experienced in women diagnosed with invasive breast cancer, a comprehensive analysis of breast cancer survival data now shows.

“Although overall age-adjusted breast cancer mortality rates were stable initially, they decreased by almost one-third, from 33.5% in 1988 to 23.5% in 2010, reported Mitchell Gail, MD, PhD, senior investigator, biostatistics branch, division of cancer epidemiology and genetics, National Cancer Institute, Rockville, Md., and colleagues online in the Journal of Clinical Oncology.

“Improvements were evident in women younger than age 70 years with distant stage at time of diagnosis, as well as in those with local and regional disease. Tumor size usually accounted for more of the improvement in the first 5 years after diagnosis rather than later on, the researchers said.

” ‘Breast cancer mortality rates following diagnosis have been decreasing over four decades, not only in the first five years after diagnosis but thereafter,’ Gail told MedPage Today. ‘Little of the improvement could be explained by changes in tumor size or estrogen-receptor (ER) status over time in women under age 70. This suggests a major contribution from treatment for these women.’ “


Postmenopausal Breast Cancer Risk Decreases Rapidly After Starting Reg. Physical Activity

“Postmenopausal women who in the past four years had undertaken regular physical activity equivalent to at least four hours of walking per week had a lower risk for invasive breast cancer compared with women who exercised less during those four years, according to data published in Cancer Epidemiology, Biomarkers Prevention, a journal of the American Association for Cancer Research.

” ‘Twelve MET-h [metabolic equivalent task-hours] per week corresponds to walking four hours per week or cycling or engaging in other sports two hours per week and it is consistent with the World Cancer Research Fund recommendations of walking at least 30 minutes daily,’ said Agnès Fournier, PhD, a researcher in the Centre for Research in Epidemiology and Population Health at the Institut Gustave Roussy in Villejuif, France. ‘So, our study shows that it is not necessary to engage in vigorous or very frequent activities; even 30 minutes per day is beneficial.’

“Postmenopausal women who in the previous four years had undertaken 12 or more MET-h of physical activity each week had a 10 percent decreased risk of invasive breast cancer compared with women who were less active. Women who undertook this level of physical activity between five and nine years earlier but were less active in the four years prior to the final collection did not have a decreased risk for invasive breast cancer.”