Types of breast cancer and their impact on elderly patients

This study examined the impact of different breast cancer subtypes in elderly patients. The study concluded that HER2+ disease had the highest rate of metastatic spread in elderly breast cancer patients.

Breast cancer is classified into different subtypes depending on the presence or absence of certain receptors. Receptors are proteins found on the surface of cancer cells that can help the cancer to grow. Breast cancer subtypes not only influence treatment options, but also directly affect disease prognosis (the likely outcome of a medical condition).

There are a number of different subtypes of breast cancer. Triple negative breast cancer (TNBC) is a cancer which is hormone receptor negative (not dependent on hormones like estrogen for growth) and HER2-negative (not dependent on HER2 for growth). HER2-positive (HER2+) breast cancer is associated with overexpression of a receptor called HER2. Most breast cancers are luminal; these are dependent on estrogen for growth. 

An older person is more likely to have other illnesses and therefore may take multiple medications. Because of this, breast cancer treatment can be more complicated in the elderly.  There is limited information available regarding the impact of breast cancer subtypes in the elderly. 

The analysis included 571 older patients (over the age of 65) with different subtypes of breast cancer. Researchers reviewed the patient’s medical history to examine the impact of the breast cancer subtypes.

After 38 months 25.4% of the patients with TNBC had experienced breast cancer recurrence (cancer had returned).  14.5% of patients with luminal breast cancer had experienced cancer recurrence. The highest rate was seen in patients with HER2+ breast cancer, with 36.1% of patients experiencing cancer recurrence.

Brain metastasis (cancer spread from the breast to the brain) occurred in 1.5% of patients with luminal breast cancer and in 3.4% of patients with TNBC. The rate was the highest in patients with HER2+ breast cancer at 7.6%. 

The current study concluded that HER2+ disease had the highest rate of metastatic spread in elderly breast cancer patients.

A limitation of this study was the lack of geriatric assessments in the patients. Geriatric assessments should be an important part of cancer care in elderly patients.