Abstract P2-11-18: Patterns of Treatment in Older Patients with Early-Stage Triple Negative Breast Cancer
Bibliographic record
Abstract
Abstract Background: Triple negative breast cancer (TNBC) comprises approximately 15-20% of breast cancer diagnoses in patients over 70 years of age. Chemotherapy has been the mainstay of treatment for both early and advanced stages of TNBC and is associated with a clear survival advantage for older patients with this aggressive subtype. Despite an aging population and an increase in the incidence of breast cancer in older patients, there remains a knowledge gap in the global treatment patterns of older patients with TNBC. Methods: A retrospective cohort study was conducted at two academic cancer centers in Canada. Adult women with stage I-III triple negative breast cancer were included from 2005 to 2023. Patients were stratified by age < 70 years (younger cohort), and ≥70 years (older cohort). Demographic, clinical, and histopathologic data were extracted from the institutional databases. Descriptive statistics were used to summarize the data and the Kaplan-Meier method was used to provide survival estimates. Results: A total of 731 patients were included with a median follow-up time of 49 months (IQR 24-79). The median age was 57 years (IQR 47-67); 20.8% of patients (n=152) were 70 years and older, whereas 79.2% (n=579) were < 70 years. Median tumor size was 22 mm (IQR 16-34) with 36.0% (n=263) having positive lymph nodes at diagnosis. Neither of these characteristics was significantly different between age groups (p=0.99, p=0.17 respectively). In terms of baseline health status, 87.5% (n=133) of the older patients had an Eastern Cooperative Oncology Group score of 0 or 1. Of the older patients, 95.4% (n=145) underwent breast surgery compared to 99.5% (n=576) of younger patients (p < 0.001). Similarly, 69.1% (n=105) of older patients underwent chemotherapy compared to 94.0% (n=544) of younger patients (p < 0.001). Immunotherapy in the early-stage setting was also differentially administered based on age group, with 5.3% (n=8) of older patients receiving it compared to 16.8% (n=97) of younger patients (p < 0.001). Chemotherapy use amongst patients ≥70 years increased over time with 41.7% receiving chemotherapy in the 2005-2010 time period as compared to 76.5% in 2015-2022 (p=0.01). Additionally, use of neoadjuvant chemotherapy (NAC) increased throughout the time period of interest with no older patient receiving NAC in the 2005-2010 interval versus 49.0% receiving NAC in 2015-2022 (p<0.001). The 5-year breast cancer-specific survival (BCSS) in the entire cohort was 89.7% (95%CI 87.2-92.3%). Five-year BCSS in older patients was 87.6% and 90.2% for the younger subgroup (p=0.64). Five-year overall survival was 77.2% in the older subgroup versus 87.5% in the younger subgroup (p<0.0001). Conclusion: In the largest Canadian cohort of patients with early-stage TNBC to date, our analysis showed that older patients continue to be undertreated compared to their younger counterparts. However, despite the age-related differences in treatment patterns, 5-year BCSS did not significantly differ by age and was higher than 85% in women ≥70 years. This excellent outcome is likely driven by the increased use of chemotherapy and preference for neoadjuvant sequencing over time in this patient population highlighting the importance of systemic therapy in older patients with TNBC. Citation Format: Mohammad Abbas, Asmaa El-Mouden, James Jing, Alex Cai, Stephanie M. Wong, Mark Basik, Jean-Francois Boileau, Karyne Martel, Miranda Bassel, Sarkis Meterissian, Ipshita Prakash. Patterns of Treatment in Older Patients with Early-Stage Triple Negative Breast Cancer [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2024; 2024 Dec 10-13; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(12 Suppl):Abstract nr P2-11-18.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".