WEDNESDAY, Sept. 7 (HealthDay News) -- For most women with breast cancer who are node negative and have estrogen receptor-positive and/or progesterone receptor-positive tumors, mortality risk is associated with age and tumor size, according to a study published online Aug. 31 in the Journal of the National Cancer Institute.
Peer Christiansen, M.D., from the Aarhus University Hospital in Denmark, and colleagues defined subgroups of patients who may benefit from adjuvant endocrine therapy. A total of 3,197 untreated patients with breast cancer who were node negative and had hormone-receptor-positive tumors were characterized by risk factors, including age at surgery, tumor size, and histopathology. Standardized mortality ratios (SMRs) were determined based on the mortality rate among the patients relative to the mortality rate in the general female population.
The investigators found that there were 970 deaths compared to 737 expected deaths (SMR, 1.32). Mortality rates were found to be 2,356 and 1,790 per 100,000 person-years in the study and general female population, respectively. The mortality rate was correlated with larger tumor size (SMR, 1.42 for 11 to 20 mm tumors versus 1.12 for tumors of 1 to 10 mm), and age (35 to 59 years; SMR, >1), except for a small subgroup of patients age 60 to 74 years, with tumors ≤10 mm, grade 1 ductal carcinoma, and grade 1 or 2 lobular carcinoma.
"A small subgroup of breast cancer patients who were 60 years or older and had hormone-responsive early-stage tumors up to 10 mm, and received no systemic adjuvant therapy, were not at increased risk of mortality compared with women in this age group in the general population" the authors write.
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