Breast Cancer Therapy in Women Under 35 Years and Women Aged 50-69 Years: Influence of the Therapy Period

Abstract Purpose:In recent years, therapeutic strategies based on tumour biology have increased significantly. The aim of this study was to provide an overview of the recent changes in patient characteristics, treatment procedures and survival factors for two groups of patients: patients younger than 35 years and patients between 50 and 69 years who belong to the screening group. Methods:For this purpose, data from the population-based Cancer Registry of Magdeburg was used. Subjects included women with non-metastatic breast cancer treated between 2000 and 2015. A comparison was made between two observation periods: 2000-2007 and 2008-2015. Results:The findings report continuous increases in patient survival. Tumour characteristics and treatment modalities changed, especially in the group of older patients. The proportion of prognostically more favourable tumour subtypes, such as Luminal A, increased significantly (30.6% vs. 36.2% resp. 47.1% vs. 64.2%). Between 2008 - 2015, more often hormone receptor-positive, nodal negative, HER2-negative and well-differentiated tumours were observed. Surgical methods were associated with significantly reduced radicality, while the rate of neoadjuvant therapy increased (17.3% vs. 47.1% vs. 11.0% vs. 20.3%) in both groups. Observations reported show a decrease in CMF (Cyclophosphamid, Methotrexat, 5-Fluoruracil) and anthracycline therapies, taxane-containing chemotherapy grew. While tamoxifen was increasingly used in younger patients (40.0% vs. 73.7%), it was superseded by aromatase inhibitors in older patients (52.8% vs. 31.4%). Furthermore, immune therapy received higher approval.Conclusion:Overall, in both age groups, but primarily in older patients, we observed significant changes in tumour biology and treatment options. This led to a continuous improvement in patient outcomes.