Authors: J Jueckstock F Kasch B Jaeger A Schramm W Janni C Scholz
Publish Date: 2015/05/03
Volume: 292, Issue: 5, Pages: 1101-1107
Abstract
Decisions on the type of adjuvant treatment in older breast cancer patients are challenging Side effects of chemotherapy have to be weighed against life expectancy comorbidities functional status and frailty on the basis of studies usually excluding patients over 69 years To aid this decision we analyzed a database of 6000 unselected patients and of those evaluated elderly primary breast cancer patients with hormone receptornegative tumors from 1963 until 2003 in respect of survival data depending on adjuvant treatmentA total of 131 elderly ie 65 years patients were observed retrospectively for a median of 72 months Patients received breastconserving therapy or mastectomy and adjuvant radiotherapy chemotherapy and endocrine therapy Data were collected from a hospitalintern databaseMedian age at diagnosis was 72 years Mostly tumors were small 81 T1 17 T2 but of unfavorable grading 40 G2 35 G3 Lymph nodes were positive in 42 Mastectomy was performed in 65 While 42 of patients received radiotherapy only 10 were treated with chemotherapy Patients with G2 and G3 tumors p = 0027 younger women p = 0012 and patients with positive lymph node status p 00001 more likely received chemotherapy Recurrencefree survival was longer in patients without chemotherapy 37 vs 29 months p = 0234 Overall survival was nonsignificantly shorter in patients who received chemotherapy 59 vs 81 months p = 0131In this analysis adjuvant chemotherapy was not associated with improved survival presumably caused by an a priori poor prognosis of these patients For an aging society more data are urgently needed to help selecting and personalizing adjuvant treatment within subgroups of breast cancer in older women
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