Adjuvant Chemotherapy in Older and Younger Women With Lymph Node–Positive Breast Cancer

Abstract

HE INCIDENCE OF BREAST CANcer increases with increasing age, and almost half of all new breast cancers in the United States now occur in women 65 years of age or older. 1 Systemic adjuvant chemotherapy in women with early-stage breast cancer significantly improves both relapse-free and overall survival for women aged 50 to 69 years old, but data are lacking for women aged 70 years or older. 2 Nevertheless, available data suggest that systemic adjuvant chemotherapy may be significantly underused in older patients, 3 even though for many patients in this setting, chemotherapy may improve survival. Moreover, even when chemo-For editorial comment see p 1118.

Achieving Optimal Dose Intensity with Adjuvant Chemotherapy in Elderly Breast Cancer Patients: A 10-Year Retrospective Study in a UK Institution

“…Furthermore, our study found that 23.8% of patients required hospitalization during treatment, whereas institution audit figures revealed a hospitalization rate of 12% across all age groups. The findings are therefore in agreement with some reports of increased toxicity with adjuvant chemotherapy in older patients (15), and may have been a consequence of clinicians’ attempts to maintain adequate dose intensity. Our high hospitalization rate thus emphasizes the need for proactive supportive care to complement optimally dosed chemotherapy in these older patients, for example with primary G‐CSF prophylaxis.…”

Cross-Canada Differences in Early-Stage Breast Cancer Treatment and Acute-Care Use

“…Those findings are consistent with two previous studies in the United States that demonstrated an effect of distance to radiation therapy on the likelihood of a patient undergoing mastectomy 20,21 . The observed association between increased age and decreased use of chemotherapy across all provinces is consistent with previous findings [22][23][24] despite evidence that chemotherapy-related improvements in patient outcomes extend to older women. Stage and receptor status were associated with receipt of chemotherapy in all provinces, an observation similar to those in previous reports from China and the United States 22,25 and Too few cases to report.…”

Breast-conserving surgery without axillary lymph node surgery or radiotherapy is safe for HER2-positive and triple negative breast cancer patients over 70 years of age

“…Cox analysis revealed that HR and molecular type were significantly related to DFS and OS, with the prognosis of HR-positive patients better than that of HR-negative patients and the prognosis of luminal A patients better than that of individuals with other molecular types, consistent with previous studies [7,8]. In addition, Cox analysis revealed that age was related to OS, with older patients have a worse OS than younger patients, similar to the findings of previous reports [4,5]. In addition, age had a greater impact on OS than other biological tumor characteristics, likely due to the fact that older patients have more senile diseases that might affect OS [6].…”