Table 1.
Parameters Used to Estimate the Natural History of Breast Cancer in Older Women
| Parameter | Estimate | Source | |||
|---|---|---|---|---|---|
| In Situ % | Local (%) | Regional (%) | Distant % | ||
| Stage distribution for screen-detected breast cancer cases, 1995–2001* | |||||
| Age, y | |||||
| 50–54 | 27 | 45 | 23.5 | 4.5 | Breast Cancer |
| 55–59 | 21 | 50 | 24 | 4 | Surveillance |
| 60–64 | 24 | 52 | 20.5 | 4.5 | Consortium, |
| 65–69 | 22 | 54 | 20.5 | 4.5 | personal written |
| 70–74 | 18 | 56 | 21 | 5 | communication |
| 75–79 | 18 | 58 | 18.5 | 6.5 | 2002, Diane Miglioretti, PhD, and31 |
| 80–84 | 17 | 59 | 17.5 | 6.5 | |
| 85+ | 14 | 64 | 14.5 | 7.5 | |
| Stage distribution for non–screen-detected breast cancer cases, 1975–1979* | |||||
| Age, y | 29 | ||||
| 50–54 | 6.0 | 45.0 | 41.7 | 7.3 | |
| 55–59 | 3.9 | 44.0 | 42.8 | 9.3 | |
| 60–64 | 3.7 | 45.6 | 40.2 | 10.5 | |
| 65–69 | 3.3 | 46.66 | 38.8 | 11.2 | |
| 70–74 | 3.3 | 47.9 | 37.8 | 11.0 | |
| 75–79 | 3.0 | 49.5 | 36.8 | 10.7 | |
| 80–84 | 2.4 | 48.4 | 37.1 | 12.1 | |
| 85+ | 1.9 | 42.0 | 39.7 | 16.4 | |
| Annual transition probabilities | Mean (SD) | 32–34 |
|---|---|---|
| P(DCIS-DCIS) | 0.714 (0.452) | |
| P(DCIS-Local) | 0.286 (0.452) | |
| P(Local-Local) | 0.828 (0.377) | |
| P(Local-Regional) | 0.172 (0.377) | |
| P(Regional-Regional) | 0.916 (0.201) | |
| P(Regional-Distant) | 0.084 (0.201) | |
| P(Distant-Distant) | 1 (0) | |
| Dwell time by age, y | 35,36 | |
| 50–59 | 2.1 | |
| 60–69 | 3 | |
| 70+ | 4.7 | |
| Mammography sensitivity | (%) | 37,38 |
| First screen | ||
| 50–59 | 93.6 | |
| 60–69 | 94.1 | |
| 70+ | 91.2 | |
| Subsequent screens | ||
| <50 | 76.5 | |
| 50+ | 73.8 | |
| Mammography specificity | 37,38 | |
| First screen | ||
| 50–59 | 92.9 | |
| 60–69 | 92.6 | |
| 70+ | 93.4 | |
| Subsequent screens | ||
| <50 | 98.1 | |
| 50+ | 98.2 |
| Mammography use: percent of all women 65+having reported mammogram in past 2 years | Median % (Low–High) | 39 |
|---|---|---|
| 73.7 (56.5–83.6) | ||
| Estrogen receptor positivity | 15 | |
| by age, y | ||
| 50–64 | 72.0% (95% CI, 76% to 77%) | |
| 65–79 | 82.0% (95% CI, 78% to 86%) |
| Distribution of local treatment for women diagnosed with breast cancer between 1993–1997 | BCS (%) | BCS+RT (%) | MST (%) | 29 |
|---|---|---|---|---|
| Age, y | ||||
| DCIS | ||||
| 50–54 | 34.0 | 38.8 | 27,2 | |
| 55–59 | 34.4 | 35.9 | 29.7 | |
| 60–64 | 31.2 | 36.0 | 32.8 | |
| 65–69 | 32.2 | 35.2 | 32.5 | |
| 70–74 | 26.9 | 37.3 | 35.8 | |
| 75–79 | 21.2 | 43.3 | 35.5 | |
| 80–84 | 17.1 | 52.7 | 30.2 | |
| 85+ | 9.4 | 62.9 | 27.7 | |
| Local | ||||
| 50–54 | 12.1 | 54.1 | 33.8 | |
| 55–59 | 10.9 | 51.1 | 38.0 | |
| 60–64 | 10.2 | 47.8 | 42.1 | |
| 65–69 | 10.5 | 43.6 | 45.9 | |
| 70–74 | 12.0 | 41.2 | 46.8 | |
| 75–79 | 17.1 | 34.3 | 48.6 | |
| 80–84 | 26.4 | 24.8 | 48.8 | |
| 85+ | 45.5 | 11.6 | 42.8 | |
| Regional | ||||
| 50–54 | 11.4 | 29.5 | 59.1 | |
| 55–59 | 9.3 | 27.5 | 63.2 | |
| 60–64 | 9.4 | 26.7 | 63.9 | |
| 65–69 | 7.1 | 22.3 | 70.6 | |
| 70–74 | 6.1 | 21.0 | 72.9 | |
| 75–79 | 6.2 | 18.2 | 75.6 | |
| 80–84 | 8.7 | 12.4 | 79.0 | |
| 85+ | 17.7 | 5.5 | 76.8 | |
| Distant | ||||
| 50–54 | 17.4 | 12.2 | 70.4 | |
| 55–59 | 16.7 | 13.6 | 69.7 | |
| 60–64 | 22.0 | 15.0 | 63.0 | |
| 65–69 | 26.5 | 12.3 | 61.3 | |
| 70–74 | 21.7 | 13.0 | 65.4 | |
| 75–79 | 25.3 | 9.8 | 64.9 | |
| 80–84 | 37.0 | 11.6 | 51.4 | |
| 85+ | 29.2 | 11.3 | 59.4 |
| Systemic treatment distribution by age and stage | (%) | 40 | |||
|---|---|---|---|---|---|
| Chemo | Tamoxifen | Both | Neither | ||
| Local | |||||
| Age 50–64 | 13.6 | 40.1 | 10.9 | 35.3 | |
| Age≥65 | 2.0 | 48.7 | 0.3 | 49.0 | |
| Regional/distant | |||||
| Age 50–64 | 26.6 | 18.8 | 42.3 | 12.3 | |
| Age≥65 | 11.4 | 45.0 | 23.4 | 20.2 | |
*
Women reported as unknown stage were distributed as follows: 50% as regional and 50% as distant based on survival.
Chemo, chemotherapy; BCS, breast-conserving therapy; MST, mastectomy; RT, radiation therapy; DCIS, ductal carcinoma in situ.