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- Title
Effect of undertreatment on the disparity in age-related breast cancer-specific survival among older women.
- Authors
Cynthia Owusu; Timothy Lash; Rebecca Silliman
- Abstract
AbstractObjectives Assess the relationship between age and breast cancer-specific survival among older women and determine whether the observed age-related disparities in survival is explained by differences in breast cancer treatments received.Methods Women ≥65 years old at diagnosis with stage I–IIIA breast cancer diagnosed between 1997 and 1998 were recruited from four regions of the United States and followed prospectively for 5 years after diagnosis. Data was obtained from tumor registries, medical records, and telephone interviews. The primary endpoint was breast cancer-specific survival. Our independent variables were age operationalized as ≤75 years vs. >75 years, and receipt of recommended guideline therapy, adapted from the National Institutes of Health guideline consensus conference.Results Of 689 women, 36% were >75 years. Women >75 years were less likely to have received the following; axillary lymph node dissection (84% vs. 93%,P = 0.0003), radiotherapy (40% vs. 54%,P = 0.0003), definitive primary therapy (71% vs. 84%,P < 0.0001), chemotherapy (9% vs. 28%,P < 0.0001), and guideline therapy (31% vs. 54%,P < 0.0001). The 5-year breast cancer-specific survival was 95% (95% confidence interval [CI], 90%, 97%) for those ≤75 years who received guideline therapy, 94% (95% CI, 90%, 97%) for those ≤75 years who did not receive guideline therapy, 96% (95% CI, 88%, 99%) for those >75 years who received guideline therapy and 83% (95% CI, 74%, 89%) for those >75 years who did not receive guideline therapy, (P = 0.002) by the log-rank test.Conclusion Receipt of guideline therapy may reduce the age-related disparity in breast cancer survival among older women.
- Publication
Breast Cancer Research & Treatment, 2007, Vol 102, Issue 2, p227
- ISSN
0167-6806
- Publication type
Academic Journal
- DOI
10.1007/s10549-006-9321-x