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Incident comorbidities and all-cause mortality among 5-year survivors of Stage I and II breast cancer diagnosed at age 65 or older: a prospective-matched cohort study.

Authors
  • Jordan, Jennifer H
  • Thwin, Soe Soe
  • Lash, Timothy L
  • Buist, Diana S M
  • Field, Terry S
  • Haque, Reina
  • Pawloski, Pamala A
  • Petersen, Hans V
  • Prout, Marianne N
  • Quinn, Virginia P
  • Yood, Marianne Ulcickas
  • Silliman, Rebecca A
  • Geiger, Ann M
Type
Published Article
Journal
Breast Cancer Research and Treatment
Publisher
Springer-Verlag
Publication Date
Jul 01, 2014
Volume
146
Issue
2
Pages
401–409
Identifiers
DOI: 10.1007/s10549-014-3021-8
PMID: 24939060
Source
Medline
License
Unknown

Abstract

Five-year breast cancer survivors, diagnosed after 65 years of age, may develop more incident comorbidities than similar populations free of cancer. We investigated whether older breast cancer survivors have a similar comorbidity burden 6-15 years after cancer diagnosis to matched women free of breast cancer at start of follow-up and whether incident comorbidities are associated with all-cause mortality. In this prospective cohort study, 1,361 older 5-year early-stage breast cancer survivors diagnosed between 1990 and 1994 and 1,361 age- and health system-matched women were followed for 10 years. Adjudicated medical record review captured prevalent and incident comorbidities during follow-up or until death as collected from the National Death Index. Older 5-year breast cancer survivors did not acquire incident comorbidities more often than matched women free of breast cancer in the subsequent 10 years [hazard ratio (HR) 1.0, 95 % confidence interval (95 % CI) 0.93, 1.1]. Adjusted for cohort membership, women with incident comorbidities had a higher mortality rate than those without incident comorbidities (HR 4.8, 95 % CI 4.1, 5.6). A breast cancer history continued to be a hazard for mortality 6-15 years after diagnosis (HR 1.3, 95 % CI 1.1, 1.4). We found that older breast cancer survivors who developed comorbidities had an increased all-cause mortality rate even after adjusting for age and prevalent comorbidity burden. Additionally, survivors acquire comorbidities at a rate similar to older women free of breast cancer. These results highlight the association between comorbidity burden and long-term mortality risk among older breast cancer survivors and their need for appropriate oncology and primary care follow-up.

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