Evidence map›Paper›PMID 40373794›Full record

SynthesisJNCI cancer spectrum2025

Treatment strategies for triple-negative primary breast cancer in older women: a systematic review.

Buraq Ahmed, Qutaiba Al-Khames Aga, Kwok-Leung Cheung, Jana de Boniface, Michael Gnant, Maria-Joao Cardoso, Emad Rakha, Thiraviyam Elumalai, Nadia Harbeck, Orit Kaidar-Person and 1 more

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in JNCI cancer spectrum, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Buraq AhmedMedical School, University of Cambridge, Cambridge, United Kingdom.ORCID 0009-0001-4351-9510
Qutaiba Al-Khames AgaSchool of Pharmacy, University of Waterloo, Waterloo, Canada.ORCID 0000-0002-1165-008X
Kwok-Leung CheungSchool of Medicine, University of Nottingham, Derby, United Kingdom.ORCID 0000-0003-2973-0755
Jana de BonifaceDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden, and Department of Surgery, Capio St Göran's Hospital, Stockholm, Sweden.ORCID 0000-0001-9518-0902
Michael GnantComprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.ORCID 0000-0003-1002-2118
Maria-Joao CardosoBreast Unit, Champalimaud Foundation and Lisbon University Faculty of Medicine, Lisbon, Portugal.
Emad RakhaPathology Department, University of Nottingham, and Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom.
Thiraviyam ElumalaiBreast Oncology, Cambridge University Hospitals, Cambridge, United Kingdom.
Nadia HarbeckBreast Center, Department of OB&GYN and CCCMunich, LMU University Hospital, Munich, Germany.ORCID 0000-0002-9744-7372
Orit Kaidar-PersonBreast Radiation Unit, Sheba Tel Hashomer, Ramat Gan, Israel.
Amit AgrawalMedical School, University of Cambridge, Cambridge, United Kingdom.ORCID 0000-0002-3144-0493

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAlthough the relative proportion of triple-negative breast cancer decreases with age, its prevalence is rising with an aging population. This study examined real-world treatment practices, whether age in older women with triple-negative breast cancer affects therapy and outcomes, focusing on the potentially curable nature of early-stage triple-negative breast cancer.

methodsA Preferred Reporting Items for Systematic Reviews and Meta-Analyses, PRISMA-compliant search using population, intervention, comparison, outcomes criteria identified literature from 2014 to 2023 across 5 databases (MEDLINE, Embase, PubMed, Web of Science, and Scopus), focusing on women aged 65 years and older with early-stage triple-negative breast cancer.

resultsFrom 7171 records, 37 studies were included. Older women with triple-negative breast cancer exhibited less aggressive features, including lower Ki67, higher androgen receptor, and higher Bcl2 expression. Breast-conserving surgery with radiation therapy (RT) was associated with improved overall survival and breast cancer-specific survival, with fewer recurrences compared with mastectomy with or without RT. Older women with triple-negative breast cancer were more likely to receive RT than systemic therapy, and the lack of RT correlated with worse outcomes. Multivariate analyses showed that systemic treatment improved 5-year overall survival and breast cancer-specific survival. Overall, outcomes did not show significant differences between women aged 70 years and older and women younger than 70 years at a median follow-up of 46 months.

conclusionsThe lack of overall outcome improvements for older women with triple-negative breast cancer following treatment may not solely be due to absent targetable receptors because the intrinsic biology in older patients may be relatively favorable. Instead, treatment selection biases against active treatment due to age-related factors may contribute substantially. Treatment decisions should be biology based and guided by a multidisciplinary, holistic, and patient-centered approach that carefully considers comorbidities, functional status, social support, and patient preferences.

Indexed as

Triple Negative Breast NeoplasmsAgedAged, 80 and overAge FactorsFemaleHumansKi-67 AntigenMastectomyMastectomy, SegmentalNeoplasm Recurrence, LocalProto-Oncogene Proteins c-bcl-2Receptors, AndrogenAR protein, humanBCL2 protein, humanKi-67 AntigenProto-Oncogene Proteins c-bcl-2Receptors, Androgen

Identifiers

PMID40373794
PMCPMC12199755

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.