Adjuvant chemotherapy in elderly women with breast cancer (AChEW): an observational study identifying MDT perceptions and barriers to decision making

Tumor biology in older breast cancer patients – What is the impact on survival stratified for guideline adherence? A retrospective multi-centre cohort study of 5378 patients

“…In the oBCP, side effects have led to a number of publications on treatment efficacy [19,21,24,40], consenting [23], quality of life [18,25], increasing the rate of therapy completion [17] and preoperative chemotherapy [41]. Our study follows up on these findings.…”

The association of waiting times from diagnosis to surgery with survival in women with localised breast cancer in England

“…The odds of nonstandard management, including not receiving primary surgery, not undergoing axillary node surgery, not undergoing tests for steroid receptors and not receiving radiotherapy following breast-conserving surgery have been shown to increase with age, notwithstanding tumour characteristics (Lavelle et al , 2007). There is also a reluctance to offer chemotherapy to older women (Ring et al , 2013) and they are also less likely to undergo breast-conserving surgery (Raine et al , 2010). Factors contributing to the use of nonstandard therapy include the clinicians' perceived small benefit of standard therapy, frailty and comorbidities (Biganzoli et al , 2012; Ring et al , 2013).…”

“…There is also a reluctance to offer chemotherapy to older women (Ring et al , 2013) and they are also less likely to undergo breast-conserving surgery (Raine et al , 2010). Factors contributing to the use of nonstandard therapy include the clinicians' perceived small benefit of standard therapy, frailty and comorbidities (Biganzoli et al , 2012; Ring et al , 2013). …”

Variation in care in concurrent chemotherapy administration during radiation for locally advanced cervical cancer

“…Our group previously reported that in women with high grade endometrial carcinoma, those 75-84 and 85 years or older were less likely to have received chemotherapy, compared to women younger than 55 years (OR 0.34, 95%CI 0.29-0.38 and OR 0.12, 95%CI 0.10-0.14) [8]. Similarly, in breast cancer, only 14% of women 85 and older were offered chemotherapy and only 8% actually received it [24] With an aging population, more women are at a risk of not being offered recommended therapy. Educational efforts to promote the concept of 'biological' as opposed to 'chronological' age may improve efforts in reducing this disparity.…”