Abstract
Use of adjuvant chemotherapy for breast cancer decreases with increasing age. We examined the effect of comorbidity on adjuvant chemotherapy use in older women (age >55 years) in a tertiary care Oncology Clinic. Clinic charts of new, early stage breast cancer patients over age 55 were reviewed. Multivariate analysis was used to determine the effect of age (55-64 versus > or =65 years), tumor stage, and comorbidity (Charlson score) on management. Two hundred and seventy-three charts were reviewed. Older women had a greater mean Charlson comorbidity score (0.72 versus 0.21; p<0.001). Tamoxifen use was similar in both groups (82.8% versus 81.1%, p=0.72). Chemotherapy was less frequently used in older women, regardless of nodal status: overall, 13.1% versus 45.6%, p<0.001; node-negative, 8.2% versus 32.1%, p<0.001; and node-positive, 25% versus 83.8%, p<0.001. In a multivariate analysis, lower stage, older age, and higher comorbidity were predictive of less frequent use of adjuvant chemotherapy. Though higher comorbidity was associated with less use of adjuvant chemotherapy, it did not totally account for the low use of chemotherapy in older compared to younger women. More work should be planned to dissect out specific reasons for ...Continue Reading
References
Apr 1, 1992·Cancer·L G Kessler
Mar 1, 1989·Cancer·R YancikJ W Yates
Mar 1, 1989·Journal of Gerontology·R A SillimanV Mor
May 22, 1987·JAMA : the Journal of the American Medical Association·S GreenfieldP A Ganz
Mar 1, 1987·Journal of Gerontology·J ChuL Ford
Nov 1, 1994·Journal of Clinical Epidemiology·M CharlsonJ Gold
Oct 1, 1994·Cancer·E L TrimbleM A Friedman
Jan 15, 1994·Annals of Internal Medicine·W A Satariano, D R Ragland
Jul 15, 1993·Cancer·J S GoodwinJ M Samet
Oct 1, 1993·Journal of Clinical Epidemiology·P S RomanoJ G Jollis
Oct 6, 1993·Journal of the National Cancer Institute·P A Newcomb, P P Carbone
Jan 8, 1996·Archives of Internal Medicine·C J NewschafferM Whittemore
Jun 5, 1996·Journal of the National Cancer Institute·R Ballard-BarbashL G Kessler
Nov 6, 1996·Journal of the National Cancer Institute·K C ChuB K Edwards
Sep 1, 1996·Annals of Epidemiology·J M Guralnik
Sep 1, 1996·Annals of Epidemiology·D W WestR A Hiatt
Oct 8, 1997·Cancer·R A SillimanS Greenfield
Dec 30, 1999·The New England Journal of Medicine·L F HutchinsK S Albain
Mar 17, 2001·JAMA : the Journal of the American Medical Association·R YancikJ W Yates
Sep 11, 2001·Cancer·X Du, J S Goodwin
Dec 19, 2002·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Xianglin L DuJames S Goodwin
Apr 25, 2003·Critical Reviews in Oncology/hematology·Arti HurriaClifford Hudis
Apr 25, 2003·Cancer·Angela DeMicheleSandra Norman
Jul 9, 2003·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Aron GoldhirschHans-Jörg Senn
Feb 1, 2005·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Sharon H GiordanoMelissa L Bondy
Mar 15, 2005·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·W J LouwmanJ W W Coebergh
May 17, 2005·Lancet·UNKNOWN Early Breast Cancer Trialists' Collaborative Group (EBCTCG)
Citations
Jul 27, 2010·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Heather BeckerAdama Brown
Oct 18, 2011·Breast Cancer Research and Treatment·Lotte Holm LandMarianne Ewertz
Jul 14, 2010·Journal of Psychosocial Oncology·Grassyara Pinho TolentinoRicardo Jacó de Oliveira
Feb 22, 2012·Annals of Oncology : Official Journal of the European Society for Medical Oncology·E P StavrouS Pearson
Nov 27, 2008·BMC Cancer·S Yousuf ZafarDawn T Provenzale
Mar 26, 2011·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Carriene RoordaKlaas van der Meer
Aug 29, 2012·Journal of Cancer Epidemiology·Teri L MaloSusan T Vadaparampil
May 4, 2011·Critical Reviews in Oncology/hematology·Lotte Holm LandMarianne Ewertz
Jan 20, 2009·Critical Reviews in Oncology/hematology·Chuan-Dong MaZhen-Zhou Shen
Mar 4, 2008·The Breast Journal·Sarah HughesMary O'Brien
Sep 11, 2012·The Breast Journal·Paramjeet KaurCharles E Cox
Feb 12, 2014·Journal of the American Geriatrics Society·Gretchen KimmickUNKNOWN Centers for Disease Control and Prevention National Program of Cancer Registry Patterns of Care Study Group
Apr 2, 2014·International Journal of Breast Cancer·Robert I GriffithsMark D Danese
Jun 29, 2016·Journal of Cancer Research and Clinical Oncology·C W WallwienerB Krämer
May 10, 2007·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Christine BouchardyGeorges Vlastos
Jul 31, 2014·Journal of Oncology Practice·Heidi D KlepinGretchen G Kimmick
Nov 26, 2010·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Linda LeeMonika K Krzyzanowska
Aug 5, 2017·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·E B MothP Blinman
Jun 4, 2020·The Breast Journal·Carol A Parise, Vincent Caggiano
May 22, 2017·Breast Cancer Research and Treatment·Melissa J EdwardsMarion J Kuper-Hommel
Nov 28, 2018·Journal of Gynecologic Oncology·Violante Di DonatoPierluigi Benedetti Panici
Feb 23, 2020·Cancer Causes & Control : CCC·Loredana SantoJill J Ashman
Nov 13, 2020·International Journal of Cancer. Journal International Du Cancer·Oluwatosin A AyeniValerie A McCormack
Sep 1, 2012·Annals of Oncology : Official Journal of the European Society for Medical Oncology·E P StavrouS Pearson