Factors Influencing Treatment Patterns in Breast Cancer Patients Age 75 and Over

To retrospectively determine the factors influencing treatment decisions in older breast cancer patients at a single center. Experimental Design: 216 patients age > or = 75 seen in post-treatment follow-up between January, 1997 and June, 2000 were identified in the Memorial Sloan-Kettering breast...

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Main Authors: HURRIA, Arti, Leung, Denis H. Y., TRAINOR, Kathleen, BORGEN, Patrick, NORTON, Larry, HUDIS, Clifford
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Language:English
Published: Institutional Knowledge at Singapore Management University 2003
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Online Access:https://ink.library.smu.edu.sg/soe_research/440
https://ink.library.smu.edu.sg/context/soe_research/article/1439/viewcontent/PIIS1040842802001336.pdf
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spelling sg-smu-ink.soe_research-14392018-06-04T07:28:29Z Factors Influencing Treatment Patterns in Breast Cancer Patients Age 75 and Over HURRIA, Arti Leung, Denis H. Y. TRAINOR, Kathleen BORGEN, Patrick NORTON, Larry HUDIS, Clifford To retrospectively determine the factors influencing treatment decisions in older breast cancer patients at a single center. Experimental Design: 216 patients age > or = 75 seen in post-treatment follow-up between January, 1997 and June, 2000 were identified in the Memorial Sloan-Kettering breast cancer database. Eligible patients were > or = 75 years old at diagnosis, had a diagnosis of stage I, II, or III breast cancer, and received their follow-up care at Memorial Sloan Kettering Cancer Center. A retrospective chart review was performed. Patients were stratified by: (1) prognostic factors (age (75-79 or > or = 80), Charlson comorbidity score, tumor size, nodal status, stage, ER, PR, creatinine, albumin, hemoglobin, and liver function tests), (2) local treatment (lumpectomy, axillary lymph node dissection (AxLND), radiation (XRT), modified radical mastectomy (MRM)) and (3) systemic treatment (tamoxifen, chemotherapy). Combined local treatment was defined as (a) lumpectomy, AxLND, XRT or (b) MRM, AxLND, XRT (if tumor > or = 5 cm or > or = 4+ lymph nodes). Results: 96 patients were eligible for this study: 46 patients (75-79 years); 50 patients (> or = 80 years). The majority of patients (74%) were treated with lumpectomy but those > or = 80 were less likely to receive XRT (94% age 75-80; 45% age >80; P<0.01). Patients > or = 80 were also less likely to receive AxLND (94% age 75-79; 62% age > or = 80; P<0.01). A logistic regression model identified two independent prognostic variables for not receiving combined local treatment: increased age (P<0.01) and increased comorbidity score (P=0.01). Increased age did not correlate with increased comorbidity (P=0.48). 5.2% of patients received adjuvant chemotherapy (all age <80). 83% of ER positive patients received tamoxifen (89% age 75-79; 79% age >80). Conclusion: We hypothesize that both comorbidity and age play a significant role in influencing treatment decisions in the older breast cancer patient but these two variables are not necessarily correlated. Prospective studies are needed to determine the relative impact of these variables. 2003-05-01T07:00:00Z text application/pdf https://ink.library.smu.edu.sg/soe_research/440 info:doi/10.1016/s1040-8428(02)00133-6 https://ink.library.smu.edu.sg/context/soe_research/article/1439/viewcontent/PIIS1040842802001336.pdf http://creativecommons.org/licenses/by-nc-nd/4.0/ Research Collection School Of Economics eng Institutional Knowledge at Singapore Management University Breast cancer Older patients Econometrics Medicine and Health Sciences
institution Singapore Management University
building SMU Libraries
continent Asia
country Singapore
Singapore
content_provider SMU Libraries
collection InK@SMU
language English
topic Breast cancer
Older patients
Econometrics
Medicine and Health Sciences
spellingShingle Breast cancer
Older patients
Econometrics
Medicine and Health Sciences
HURRIA, Arti
Leung, Denis H. Y.
TRAINOR, Kathleen
BORGEN, Patrick
NORTON, Larry
HUDIS, Clifford
Factors Influencing Treatment Patterns in Breast Cancer Patients Age 75 and Over
description To retrospectively determine the factors influencing treatment decisions in older breast cancer patients at a single center. Experimental Design: 216 patients age > or = 75 seen in post-treatment follow-up between January, 1997 and June, 2000 were identified in the Memorial Sloan-Kettering breast cancer database. Eligible patients were > or = 75 years old at diagnosis, had a diagnosis of stage I, II, or III breast cancer, and received their follow-up care at Memorial Sloan Kettering Cancer Center. A retrospective chart review was performed. Patients were stratified by: (1) prognostic factors (age (75-79 or > or = 80), Charlson comorbidity score, tumor size, nodal status, stage, ER, PR, creatinine, albumin, hemoglobin, and liver function tests), (2) local treatment (lumpectomy, axillary lymph node dissection (AxLND), radiation (XRT), modified radical mastectomy (MRM)) and (3) systemic treatment (tamoxifen, chemotherapy). Combined local treatment was defined as (a) lumpectomy, AxLND, XRT or (b) MRM, AxLND, XRT (if tumor > or = 5 cm or > or = 4+ lymph nodes). Results: 96 patients were eligible for this study: 46 patients (75-79 years); 50 patients (> or = 80 years). The majority of patients (74%) were treated with lumpectomy but those > or = 80 were less likely to receive XRT (94% age 75-80; 45% age >80; P<0.01). Patients > or = 80 were also less likely to receive AxLND (94% age 75-79; 62% age > or = 80; P<0.01). A logistic regression model identified two independent prognostic variables for not receiving combined local treatment: increased age (P<0.01) and increased comorbidity score (P=0.01). Increased age did not correlate with increased comorbidity (P=0.48). 5.2% of patients received adjuvant chemotherapy (all age <80). 83% of ER positive patients received tamoxifen (89% age 75-79; 79% age >80). Conclusion: We hypothesize that both comorbidity and age play a significant role in influencing treatment decisions in the older breast cancer patient but these two variables are not necessarily correlated. Prospective studies are needed to determine the relative impact of these variables.
format text
author HURRIA, Arti
Leung, Denis H. Y.
TRAINOR, Kathleen
BORGEN, Patrick
NORTON, Larry
HUDIS, Clifford
author_facet HURRIA, Arti
Leung, Denis H. Y.
TRAINOR, Kathleen
BORGEN, Patrick
NORTON, Larry
HUDIS, Clifford
author_sort HURRIA, Arti
title Factors Influencing Treatment Patterns in Breast Cancer Patients Age 75 and Over
title_short Factors Influencing Treatment Patterns in Breast Cancer Patients Age 75 and Over
title_full Factors Influencing Treatment Patterns in Breast Cancer Patients Age 75 and Over
title_fullStr Factors Influencing Treatment Patterns in Breast Cancer Patients Age 75 and Over
title_full_unstemmed Factors Influencing Treatment Patterns in Breast Cancer Patients Age 75 and Over
title_sort factors influencing treatment patterns in breast cancer patients age 75 and over
publisher Institutional Knowledge at Singapore Management University
publishDate 2003
url https://ink.library.smu.edu.sg/soe_research/440
https://ink.library.smu.edu.sg/context/soe_research/article/1439/viewcontent/PIIS1040842802001336.pdf
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