Clin Oncology_chemo_ 30 Jan 2019_authors finalversion.pdf (293.97 kB)
Adjuvant chemotherapy for breast cancer in older women: an analysis of retrospective English cancer registration data
journal contribution
posted on 2023-06-09, 16:35 authored by S E Ward, G R Holmes, A Ring, P D Richards, J L Morgan, J W Broggio, K Collins, Malcolm ReedMalcolm Reed, L WyldAims Adjuvant chemotherapy is recommended as a treatment for women with high recurrence risk early breast cancer. Older women are less likely to receive chemotherapy than younger women. This study investigated the impact of chemotherapy on breast cancer-specific survival in women aged 70 + years using English registry data. Materials and methods Cancer registration data were obtained from two English regions from 2002 to 2012 (n = 29 728). The impact of patient-level characteristics on the probability of receiving adjuvant chemotherapy was explored using logistic regression. Survival modelling was undertaken to show the effect of chemotherapy and age/health status on breast cancer-specific survival. Missing data were handled using multiple imputation. Results In total, 11 735 surgically treated early breast cancer patients were identified. Use of adjuvant chemotherapy has increased over time. Younger age at diagnosis, increased nodal involvement, tumour size and grade, oestrogen receptor-negative or human epidermal growth factor receptor 2-positive disease were all associated with increased probability of receiving chemotherapy. Chemotherapy was associated with a significant reduction in the hazard of breast cancer-specific mortality in women with high risk cancer, after adjusting for patient-level characteristics (hazard ratio 0.74, 95% confidence interval 0.67–0.81). Discussion Chemotherapy is associated with an improved breast cancer-specific survival in older women with early breast cancer at high risk of recurrence . Lower rates of chemotherapy use in older women may, therefore, contribute to inferior cancer outcomes. Decisions on potential benefits for individual patients should be made on the basis of life expectancy, treatment tolerance and patient preference.
History
Publication status
- Published
File Version
- Accepted version
Journal
Clinical OncologyISSN
0936-6555Publisher
ElsevierExternal DOI
Department affiliated with
- BSMS Publications
Full text available
- Yes
Peer reviewed?
- Yes
Legacy Posted Date
2019-04-26First Open Access (FOA) Date
2020-05-20First Compliant Deposit (FCD) Date
2019-04-26Usage metrics
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