The Effect of Age and Comorbidity in the Treatment of Elderly Women With Nonmetastatic Breast Cancer

Newschaffer, Craig J.; Penberthy, Lynne; Desch, Christopher E.; Retchin, Sheldon M.; Whittemore, Martha

doi:10.1001/archinte.1996.00440010103014

Cited by 134 publications

(33 citation statements)

References 38 publications

(2 reference statements)

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“…The presence of such diseases has an impact on the treatment that patients with breast cancer receive, the success of that treatment, and the time required for recovery (30)(31)(32)(33). We could not determine the effect of comorbidity on LOS.…”

Section: Discussionmentioning

confidence: 99%

Factors Affecting the Postsurgical Length of Hospital Stay in Patients with Breast Cancer

et al. 2015

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Objective: Breast cancer is the most common malignancy and the most common cause of mortality in women worldwide. In addition to the increasing incidence of breast cancer, the length of hospital stay (LOS) after breast cancer surgery has been decreasing. Because LOS is key in determining hospital usage, the decrease in the use of hospital facilities may have implications on healthcare planning. The purpose of this study was to evaluate the factors affecting postoperative LOS in patients with breast cancer. Materials and Methods:Seventy-six in patients with breast cancer, who had been treated between July 2013 and December 2014 in the General Surgery Clinic of Dicle University, were included in the study. The demographic characteristics of the patients, treatment methods, histopathological features of the tumor, concomitant diseases, whether they underwent neoadjuvant chemotherapy or not, and the length of drain remaining time were retrospectively recorded.Results: There was a correlation between drain remaining time, totally removed lymph node, the number of metastatic lymph node, and LOS. LOS of patients treated with neoadjuvant chemotherapy was longer. The patients who underwent breast-conserving surgery had a shorter LOS. Linear regression analysis revealed that the drain remaining time and the number of metastatic lymph nodes were independent risk factors for LOS.

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Section: Discussionmentioning

confidence: 99%

Factors Affecting the Postsurgical Length of Hospital Stay in Patients with Breast Cancer

et al. 2015

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“…In several studies (Newschaffer et al, 1996;West et al, 1996;Lash et al, 2003), the Charlson comorbidity method (Charlson et al, 1987) was used to measure comorbidity and in other studies (Greenfield et al, 1987;Bergman et al, 1991) another measure of comorbidity was used. Although the effect of severity of comorbidity according to the 'Life Threat' model (Yancik et al, 1998) has not yet been validated in breast cancer, we believe it to be the best available index to measure severity of comorbidity in which information about treatment of the comorbid condition was included.…”

Section: Discussionmentioning

confidence: 99%

Comorbidity has negligible impact on treatment and complications but influences survival in breast cancer patients

et al. 2004

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In the present study, we investigated whether age and serious comorbid conditions influence treatment decisions, complications and survival in breast cancer patients. The Eindhoven Cancer Registry records patient, tumour and therapy characteristics of all patients diagnosed with cancer in the southern part of the Netherlands. Additional information on severity of comorbidity and serious complications was collected for a random sample of 527 breast cancer patients (aged 40 years and older). More than 70% of the patients X80 exhibited high severity of comorbidity compared to 6% of those aged 40 -49 years. Treatment was not influenced by severity of comorbidity. Less than 30% of the breast cancer patients had complications after diagnosis. The number of complications was not related to age or severity of comorbidity. The hazard ratio (HR) of dying for patients with low/moderate severity of comorbidity was 2.4 for those aged 40 -69 years and 1.6 for those aged X70 years, after adjustment for age, nodal status and treatment. For patients with high severity of comorbidity, the risk of dying was almost three times higher. Older breast cancer patients with serious comorbidity were not treated differently and did not have more complications compared to those without comorbidity, but they exhibited a worse prognosis.

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“…This finding is consistent with previous studies that suggest comorbidity fails to completely explain age-associated variations in breast carcinoma treatments. 21,22 The worldwide metaanalysis of adjuvant tamoxifen trials for early-stage breast carcinoma reported that the risk of disease recurrence in ERϩ or ERindeterminate women aged 70 or older was reduced by 22% Ϯ 9% after 1 year, 42% Ϯ 8% after 2 years, and 54% Ϯ 13% after 5 years of treatment. 5 In addition, risk of death from any cause in this age group was reduced by 36% Ϯ 7% after 2 years and 34% Ϯ 13% after 5years of treatment.…”

Section: Discussionmentioning

confidence: 99%

Advanced age and adjuvant tamoxifen prescription in early‐stage breast carcinoma patients

Blackman

Lash

Fink

et al. 2002

Cancer

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BACKGROUNDAdjuvant tamoxifen is recommended for all women with estrogen receptor‐positive breast carcinoma without regard for age. We investigated age‐dependent variations in adjuvant tamoxifen prescription patterns in a cohort of women 80 years of age and older.METHODSWe studied 92 women diagnosed at four U.S. sites with primary, early‐stage breast carcinoma. Each woman consented to a medical record review and participated in two telephone interviews. We compared the proportion of tamoxifen prescriptions received by women 85–92 years of age with those received by women 80–84 years of age. Relative risks (RR) and 95% confidence intervals (95% CI) were generated using generalized estimating equations. Confounding by demographic, disease, and treatment characteristics was assessed.RESULTSBefore adjustment, patients 85–92 years of age were 28% less likely to receive a tamoxifen prescription compared with patients 80–84 years of age (RR = 0.72, 95% CI 0.57–0.91). In this sample, patients not prescribed tamoxifen had substantially more comorbidity. After adjusting the crude finding for comorbidity, the RR was 0.74 (95% CI 0.58–0.93). In addition, the oldest patients and those not prescribed tamoxifen were significantly less likely to be married or have living children. After adjusting the crude finding for these two factors, the RR was 0.75 (95% CI 0.59–0.95). There was no confounding by the other demographic, disease, or treatment covariates assessed.CONCLUSIONGiven the increasing longevity of the oldest old, undertreatment with adjuvant tamoxifen may put older breast carcinoma patients at an increased risk of disease recurrence and breast carcinoma mortality. Cancer 2002;95:2465–72. © 2002 American Cancer Society.DOI 10.1002/cncr.10985

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The Effect of Age and Comorbidity in the Treatment of Elderly Women With Nonmetastatic Breast Cancer

Abstract: Aggregate comorbidity measured by inpatient International Classification of Diseases, Ninth Edition, codes on Medicare inpatient hospital claims does not explain age-related patterns in the initial treatment of elderly patients with breast cancer.

Cited by 134 publications

References 38 publications

Factors Affecting the Postsurgical Length of Hospital Stay in Patients with Breast Cancer

Factors Affecting the Postsurgical Length of Hospital Stay in Patients with Breast Cancer

Comorbidity has negligible impact on treatment and complications but influences survival in breast cancer patients

Advanced age and adjuvant tamoxifen prescription in early‐stage breast carcinoma patients

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