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2. Materials and Methods The medical records of women evaluated for their breast cancer in Emory University Hospital's Department of Radiation Oncology from 1997 until 2010 were reviewed. Exclusion criteria included patient age between 40 and 74 years and stage IV or inflammatory breast cancer. In addition, among patients treated with chemotherapy, selleckchem those who did not receive standard anthracycline or taxane-based treatments were excluded. In total, 230 women met eligibility criteria for this study with 125 patients below the age of 40 and 105 subjects above the age of 75. Tumor receptor status was determined by immunohistochemistry. Her-2-neu status was recorded as positive for tumors that stained 3+ on immunohistochemistry. For Her-2-neu tumors that were 2+, confirmatory fluorescence in situ hybridization (FISH) testing was performed. Tumors were staged according to the 2010 American Joint Committee on Cancer (AJCC) guidelines. Outcomes included LRFS, DRFS, and overall S6 Kinase survival (OS). LRR was defined as a biopsy proven recurrence of the primary breast cancer within the ipsilateral breast, chest wall, axillary, internal mammary, or supraclavicular lymph nodes. DR was defined as a biopsy proven recurrence in any other location of the body. Descriptive statistics were generated for all variables, summarized with frequencies and percentages. Covariates as well as predictors of LRFS, DRFS, and OS were compared across age groups using chi-squared tests or Fisher's exact tests, where appropriate. Univariate (UV) Cox proportional hazards models were fit for the outcomes listed above, using age as the primary predictor. Multivariate (MV) Cox models were fit for overall LRFS, DRFS, and OS. In addition, survival curves were Lapatinib clinical trial generated for each outcome using the Kaplan-Meier method, stratified by age group. Outcomes such as 5-year survival rates were reported for each group, and differences in 5-year survival were compared using a z-test. Univariate analysis was performed to determine predictors of LRFS in each age cohort. Significance was assessed at the 0.05 level. Survival analysis was performed in SAS 9.3, and survival curves were generated in R. Firth's penalized maximum likelihood estimation was used in the survival models, in order to reduce bias in the parameter estimates and confidence intervals, as well as handle empty cells. 3. Results 3.1. Tumor Characteristics The majority of younger women (88%) presented with cancers that were symptomatic while the majority of older women (63.1%) were more likely to have cancers detected by mammography (P