In a nutshell
This study looked at the outcomes of older women with triple-negative breast cancer who received chemotherapy before or after local treatment. The data showed that chemotherapy can be considered in the treatment of these patients.
Some background
Triple-negative breast cancer (TNBC) is a subtype of breast cancer (BC) that tests negative for female hormone receptors (estrogen and/or progesterone) and the HER2 protein. TNBC accounts for 10-15% of all BCs. It is associated with a poorer disease outcome compared to other subtypes of BC.
Treatments for TNBC usually involve a combination of surgery, chemotherapy, and radiotherapy. However, there are very few studies showing the benefits of chemotherapy in women aged 70 years or older with TNBC. Therefore, treatment decisions for older women are made from studies of younger women who were included in larger clinical studies. Whether chemotherapy improves the overall survival of older women with TNBC is still unknown.
Methods & findings
This study analyzed data from 16,062 women aged 70 years or older with stage I-III TNBC. All patients had their tumors surgically removed and were put in 3 groups. Group 1 included women who received chemotherapy before or after surgery. Group 2 included those who were recommended chemotherapy but did not receive it and group 3 included those for whom chemotherapy was not recommended and not received. The average follow-up time was 38.3 months.
The 5-year estimated overall survival rate was 68.5% for patients in group 1 compared with 61.1% for those in group 2 and 53.7% for those in group 3.
Patients who received chemotherapy were 44% more likely to have a better survival compared to those who were not recommended chemotherapy and did not receive it. This benefit was seen in both lymph node-positive (cancer spread to the lymph nodes) and node-negative patients (lymph nodes free of cancer cells) and also in women with one additional medical condition or more.
The bottom line
This study concluded that chemotherapy improved the overall survival in older women diagnosed with TNBC.
The fine print
This study was based on medical records. Information such as the type and duration of chemotherapy was missing. Also, only a small number of women (17.9%) received chemotherapy before surgery. This might affect the results.
Published By :
The Lancet. Oncology
Date :
Dec 01, 2020