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Systemic inflammation in older patients with breast cancer: the missing point in geriatric evaluations to sharpen survival prediction

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Abstract

Background

Breast cancer (BC) prevalence steadily increases in older patients but their treatment is based on the geriatric evaluations of comorbidities and potential benefits proved in clinical trials with younger patients. The lack of better decision-making tools urges to promote the search for new prognostic markers. The association between inflammation, aging and cancer may be crucial for better treatment selection. We sought to analyze its impact on the survival of older BC patients, evaluating the interaction with age and comorbidities.

Methods

We evaluated the relationship between inflammatory biomarkers at BC diagnosis (circulating blood cell counts and inflammatory indexes) and BC-related and not related mortality rate, evaluating the influence of comorbidities and age through the competitive risks assessment.

Results

We analyzed 148 consecutive BC patients aged ≥ 70 years old, diagnosed with BC and regional lymph node metastases. After the median follow-up of 51.5 months, 59 patients died (28 due to breast cancer progression and 31 because of other causes). Increased levels of circulating monocytes, neutrophils and neutrophil-to-lymphocytes ratio and decreased level of eosinophils and eosinophil multiple by neutrophils-to-lymphocytes ratio were associated with higher probability of BC-related death but not with death related to other causes.

Conclusion

Our data suggest a role of inflammatory parameters as a possible prognostic tool in therapeutic decision-making process in older patients with BC, as increased level of inflammation was associated with cancer-specific mortality. Prospective studies may give the possibility of refining the geriatric evaluation for BC treatment in elderly.

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Acknowledgements

The authors thank Mr Manuel Rain Montecinos for his generous and dedicated contribution to the statistical analysis. The authors wish also to sincerely thank Miss Joselyn Maturana, Dra. Paula Escobar, Dr. Pedro Galaz, Dr Jorge Gamboa, Dr Rodrigo Iglesis, Dr Joaquín Irarrázabal, Dr Miguel Maturana, Dr Aliro Neira and Dra Karina Peña, without their valuable support this study could not have been accomplished.

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Authors and Affiliations

  1. Radiation Oncology Department, Instituto de Radiomedicina (IRAM), Avenida Américo Vespucio 1314, Vitacura, 7630000, Santiago de Chile, Chile

    Andrés Vargas

  2. Facultad de Medicina, Universidad Diego Portales, Santiago, Chile

    Andrés Vargas

  3. Facultat de Medicina, Universitat de Barcelona, C/Casanova 143, 08036, Barcelona, Spain

    Katarzyna Holub & Albert Biete

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  1. Andrés Vargas
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Correspondence to Andrés Vargas.

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Vargas, A., Holub, K. & Biete, A. Systemic inflammation in older patients with breast cancer: the missing point in geriatric evaluations to sharpen survival prediction. Clin Transl Oncol 24, 1800–1808 (2022). https://doi.org/10.1007/s12094-022-02836-5

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