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Chemotherapy Refusal Associated With Increased Age Among Patients with Breast Cancer
According to a recent study, women ≥ 65 yearswith high genomic risk estrogen receptor positive (ER+) breast cancer refused chemotherapy as their age increased.
Using the National Cancer Database (2010-2017), 6827 women who were ≥65 years of age and had ER+/HER2-, high recurrence score (RS) breast cancer were identified. The patients were evaluated based on refusal of chemotherapy and reception of chemotherapy, factors linked to chemotherapy refusal, and overall survival (OS) by age and by treatment.
Of the 6827 total patients, 80% received chemotherapy and 20% refused. Those who refused chemotherapy were older, more recently diagnosed,had low grade tumors, and often insured with Medicare, and had progesterone receptor-positive tumors. They also received radiation less frequently. There was a significant association between chemotherapy refusal and increased age, and more recent diagnosis. Chemotherapy refusal was heavily linked to a decreased 5-year OS for patients 65-74 years of age and patients aged 75-79 years. However, those patients ≥80 years had no association due to the stratification of age.
The study authors concluded that, “Lower use of chemotherapy in women ≥80 may demonstrate pragmatic decision-making between physicians and patients… More research is needed to determine why women aged 65-79 refuse chemotherapy, and whether patients remain satisfied with these choices.”
Source:
White M, Prathibha S, Praska C, et al. Chemotherapy refusal and subsequent survival in older women with high genomic risk, estrogen receptor–positive breast cancer. J Clin Oncol. Published online June 1, 2022. doi: 10.1200/JCO.2022.40.16_suppl.520
