Elderly postmenopausal patients with breast cancer are at increased risk for distant recurrence: A Tamoxifen Exemestane Adjuvant Multinational Study Analysis

Introduction. For postmenopausal patients with hormonesensitive breast cancer, outcome is worse with increasing age at diagnosis. The aim of this study was to assess the incidenceof breast cancer recurrence (locoregionalanddistant), and contralateral breast cancer by age at diagnosis. Methods. Patients enrolled in the Tamoxifen Exemestane Adjuvant Multinational (TEAM) trial were included. Primary endpoints were locoregional recurrence, distant recurrence, and contralateralbreastcancer.Ageatdiagnosiswascategorizedas younger than 65 years, 65-74 years, and 75 years or older. Results. Overall, 9,766 patients were included, of which 5,349 were younger than 65 years (reference group), 3,060 were 65-74 years, and 1,357 were 75 years or older. With increasing age, a decreased administration of radiotherapy after breast conserving surgery (94%, 92%, and 88%, respectively) and adjuvant chemotherapy (51%, 23%, and 5%, respectively) was observed. Risk of distant recurrence increased with age at diagnosis; multivariable hazard ratio for pa