Journal
JOURNAL OF GERIATRIC ONCOLOGY
Volume 4, Issue 2, Pages 148-156Publisher
ELSEVIER
DOI: 10.1016/j.jgo.2012.12.007
Keywords
Breast neoplasm; Elderly; Adjuvant chemotherapy; Survival analysis; Risk modeling; Disease specific survival; Breast cancer
Categories
Funding
- Kaplan Cancer Research Fund
- Cancer Surveillance System of the Fred Hutchinson Cancer Research System
Ask authors/readers for more resources
Objective: To assess adjuvant chemotherapy recommendations, administration and disease-specific survival for invasive breast cancer (BC) among patients 75 years and older compared with that of younger women. Materials and Methods: A cohort of patients with primary breast cancer, aged 65-94, stages I-III from 1990 to 2010 was identified and tracked by our breast cancer registry (n=2329). Stage, treatment recommendations and outcomes were chart abstracted at diagnosis and follow-up. Associations were tested with logistic regression and the Kaplan-Meier method was used for disease-specific survival (DSS). Results: Seventy-five percent of patients aged 75+ were seen by an oncologist compared with 78% aged 70-74 and 84% aged 65-69. Women aged 75+ seen by an oncologist were more likely age 75-79, stage II/III, hormone receptor negative (HR-) or her-2/neu positive. Of these patients, age, stage and HR status were related to a chemotherapy recommendation. Of 106 patients recommended for chemotherapy, 18 refused (17%) and 24 did not complete treatment due to complications, patient choice, disease progression or death not related to treatment. DSS was equivalent for patients 75 and older with stage I BC compared to 65-74 year olds, but significantly worse in stage II and III patients, respectively (stage II 5 year DSS 90% vs. 97%, stage III 5 year DSS 65% vs. 81%). Conclusion: Patients aged 75 and older with invasive breast cancer who were recommended for adjuvant chemotherapy have a high rate of refusal and complications from therapy. Their disease specific mortality disadvantage is restricted to stage II and III patients, a group in need of effective therapy to improve disease survival. (C) 2013 Elsevier Ltd. All rights reserved.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available