{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T04:32:23Z","timestamp":1772166743641,"version":"3.50.1"},"reference-count":24,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"18","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCO"],"published-print":{"date-parts":[[2009,6,20]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To study the relation between the presence of axillary lymph node (LN) involvement and age in breast cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>The breast cancer database of the University Hospitals Leuven contains complete data on 2,227 patients with early breast cancer consecutively treated between 2000 and 2005. A multivariate piecewise logistic regression model was used to analyze LN involvement in relation to age at diagnosis. A similar analysis was then performed on a large, independent, population-based database from the Eindhoven Cancer Registry to investigate whether the effects of the Leuven model could be replicated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We observed a piecewise effect of age. That is, women up to 70 years of age were less likely to have positive LNs with increasing age (odds ratio per 10-year increase, 0.87). In contrast, older women were more likely to have positive LNs with increasing age. However, for older women, the effect of age interacted with tumor size (P = .0044), suggesting that increasing age is associated with increased risk of LN involvement, mainly in small tumors. These findings were replicated in the Eindhoven Cancer Registry database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Axillary LN involvement varies with age at diagnosis; its probability decreases with increasing age up to the age of approximately 70 years, but increases again thereafter. However, this increase is mainly seen in smaller tumors and suggests a different behavior of small breast cancers in older adult patients. We hypothesize that decreased immune defense mechanisms, related with aging, may play a role in earlier invasion into LNs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/jco.2008.16.7619","type":"journal-article","created":{"date-parts":[[2009,5,18]],"date-time":"2009-05-18T21:47:03Z","timestamp":1242683223000},"page":"2931-2937","source":"Crossref","is-referenced-by-count":73,"title":["Relationship Between Age and Axillary Lymph Node Involvement in Women With Breast Cancer"],"prefix":"10.1200","volume":"27","author":[{"given":"Hans","family":"Wildiers","sequence":"first","affiliation":[{"name":"From the Multidisciplinary Breast Centre and Departments of General Medical Oncology, Pathology, Gynecology, and Radiotherapy, University Hospitals Leuven; Department of Electrical Engineering, Katholieke Universiteit Leuven, Leuven, Belgium; Comprehensive Cancer Centre South, Eindhoven Cancer Registry, Eindhoven, the Netherlands; and Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Norway."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ben","family":"Van Calster","sequence":"additional","affiliation":[{"name":"From the Multidisciplinary Breast Centre and Departments of General Medical Oncology, Pathology, Gynecology, and Radiotherapy, University Hospitals Leuven; Department of Electrical Engineering, Katholieke Universiteit Leuven, Leuven, Belgium; Comprehensive Cancer Centre South, Eindhoven Cancer Registry, Eindhoven, the Netherlands; and Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Norway."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lonneke V.","family":"van de Poll-Franse","sequence":"additional","affiliation":[{"name":"From the Multidisciplinary Breast Centre and Departments of General Medical Oncology, Pathology, Gynecology, and Radiotherapy, University Hospitals Leuven; Department of Electrical Engineering, Katholieke Universiteit Leuven, Leuven, Belgium; Comprehensive Cancer Centre South, Eindhoven Cancer Registry, Eindhoven, the Netherlands; and Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Norway."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wouter","family":"Hendrickx","sequence":"additional","affiliation":[{"name":"From the Multidisciplinary Breast Centre and Departments of General Medical Oncology, Pathology, Gynecology, and Radiotherapy, University Hospitals Leuven; Department of Electrical Engineering, Katholieke Universiteit Leuven, Leuven, Belgium; Comprehensive Cancer Centre South, Eindhoven Cancer Registry, Eindhoven, the Netherlands; and Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Norway."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jo","family":"R\u00f8islien","sequence":"additional","affiliation":[{"name":"From the Multidisciplinary Breast Centre and Departments of General Medical Oncology, Pathology, Gynecology, and Radiotherapy, University Hospitals Leuven; Department of Electrical Engineering, Katholieke Universiteit Leuven, Leuven, Belgium; Comprehensive Cancer Centre South, Eindhoven Cancer Registry, Eindhoven, the Netherlands; and Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Norway."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ann","family":"Smeets","sequence":"additional","affiliation":[{"name":"From the Multidisciplinary Breast Centre and Departments of General Medical Oncology, Pathology, Gynecology, and Radiotherapy, University Hospitals Leuven; Department of Electrical Engineering, Katholieke Universiteit Leuven, Leuven, Belgium; Comprehensive Cancer Centre South, Eindhoven Cancer Registry, Eindhoven, the Netherlands; and Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Norway."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Paridaens","sequence":"additional","affiliation":[{"name":"From the Multidisciplinary Breast Centre and Departments of General Medical Oncology, Pathology, Gynecology, and Radiotherapy, University Hospitals Leuven; Department of Electrical Engineering, Katholieke Universiteit Leuven, Leuven, Belgium; Comprehensive Cancer Centre South, Eindhoven Cancer Registry, Eindhoven, the Netherlands; and Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Norway."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Deraedt","sequence":"additional","affiliation":[{"name":"From the Multidisciplinary Breast Centre and Departments of General Medical Oncology, Pathology, Gynecology, and Radiotherapy, University Hospitals Leuven; Department of Electrical Engineering, Katholieke Universiteit Leuven, Leuven, Belgium; Comprehensive Cancer Centre South, Eindhoven Cancer Registry, Eindhoven, the Netherlands; and Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Norway."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karin","family":"Leunen","sequence":"additional","affiliation":[{"name":"From the Multidisciplinary Breast Centre and Departments of General Medical Oncology, Pathology, Gynecology, and Radiotherapy, University Hospitals Leuven; Department of Electrical Engineering, Katholieke Universiteit Leuven, Leuven, Belgium; Comprehensive Cancer Centre South, Eindhoven Cancer Registry, Eindhoven, the Netherlands; and Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Norway."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline","family":"Weltens","sequence":"additional","affiliation":[{"name":"From the Multidisciplinary Breast Centre and Departments of General Medical Oncology, Pathology, Gynecology, and Radiotherapy, University Hospitals Leuven; Department of Electrical Engineering, Katholieke Universiteit Leuven, Leuven, Belgium; Comprehensive Cancer Centre South, Eindhoven Cancer Registry, Eindhoven, the Netherlands; and Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Norway."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabine","family":"Van Huffel","sequence":"additional","affiliation":[{"name":"From the Multidisciplinary Breast Centre and Departments of General Medical Oncology, Pathology, Gynecology, and Radiotherapy, University Hospitals Leuven; Department of Electrical Engineering, Katholieke Universiteit Leuven, Leuven, Belgium; Comprehensive Cancer Centre South, Eindhoven Cancer Registry, Eindhoven, the Netherlands; and Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Norway."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie-Rose","family":"Christiaens","sequence":"additional","affiliation":[{"name":"From the Multidisciplinary Breast Centre and Departments of General Medical Oncology, Pathology, Gynecology, and Radiotherapy, University Hospitals Leuven; Department of Electrical Engineering, Katholieke Universiteit Leuven, Leuven, Belgium; Comprehensive Cancer Centre South, Eindhoven Cancer Registry, Eindhoven, the Netherlands; and Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Norway."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Neven","sequence":"additional","affiliation":[{"name":"From the Multidisciplinary Breast Centre and Departments of General Medical Oncology, Pathology, Gynecology, and Radiotherapy, University Hospitals Leuven; Department of Electrical Engineering, Katholieke Universiteit Leuven, Leuven, Belgium; Comprehensive Cancer Centre South, Eindhoven Cancer Registry, Eindhoven, the Netherlands; and Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Norway."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"233","reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.20535"},{"key":"B2","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1093\/geronj\/47.5.S222","volume":"47","author":"Clark GM","year":"1992","journal-title":"J Gerontol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/92.7.550"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/S1040-8428(02)00144-0"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.2910620205"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.1997.103"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.20206"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/S0748-7983(98)80120-0"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1016\/j.critrevonc.2006.01.007"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-007-9687-4"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/0304-4076(88)90077-2"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1177\/096228029900800102"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1002\/9781119013563"},{"key":"B14","first-page":"221","volume":"14","author":"Balducci L","year":"2000","journal-title":"Oncology (Huntingt)"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1045"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4757-2917-7"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1001\/jama.285.7.885"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000167759.15670.14"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2004.22.14_suppl.505"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1016\/j.breast.2004.04.012"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1152\/physiol.00040.2007"},{"key":"B22","first-page":"403","volume":"48","author":"Goodwin JS","year":"1982","journal-title":"Clin Exp Immunol"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1054\/brst.1999.0147"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1023\/A:1006405504158"}],"container-title":["Journal of Clinical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ascopubs.org\/doi\/pdfdirect\/10.1200\/JCO.2008.16.7619","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,25]],"date-time":"2022-05-25T19:23:49Z","timestamp":1653506629000},"score":1,"resource":{"primary":{"URL":"https:\/\/ascopubs.org\/doi\/10.1200\/JCO.2008.16.7619"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,6,20]]},"references-count":24,"journal-issue":{"issue":"18","published-print":{"date-parts":[[2009,6,20]]}},"alternative-id":["10.1200\/JCO.2008.16.7619"],"URL":"https:\/\/doi.org\/10.1200\/jco.2008.16.7619","relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.1165470.628459","asserted-by":"object"}]},"ISSN":["0732-183X","1527-7755"],"issn-type":[{"value":"0732-183X","type":"print"},{"value":"1527-7755","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,6,20]]}}}