Originally published as JCO Early Release 10.1200/JCO.2008.18.3459 on August 17 2009

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via HighWire Google Scholar Articles by Buist, D. S.M. Articles by Silliman, R. A. PubMed PubMed Citation Articles by Buist, D. S.M. Articles by Silliman, R. A. Social Bookmarking                            What's this?

Referral, Receipt, and Completion of Chemotherapy in Patients With Early-Stage Breast Cancer Older Than 65 Years and at High Risk of Breast Cancer Recurrence

From the Group Health Center for Health Studies, Seattle, WA; Boston University School of Public Health, Department of Epidemiology; and Boston University School of Medicine, Section of Geriatrics, Boston; and Meyers Primary Care Institute, Fallon Community Health Plan/Fallon Foundation/University of Massachusetts Medical School, Worcester, MA; Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT; Josephine Ford Cancer Center, Henry Ford Health System, Detroit, MI; Weill Cornell Medical College, New York, NY; Division of Hematology/Oncology, University Hospitals of Cleveland, Cleveland OH; Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA; and HealthPartners Research Foundation, Minneapolis MN.

Corresponding author: Diana S.M. Buist, PhD, Group Health Center for Health Studies, 1730 Minor Ave, Suite 1600, Seattle, WA, 98101; e-mail: buist.d{at}ghc.org.

Purpose Some women with early-stage breast cancer are at higher risk of recurrence and can benefit from chemotherapy. We describe patterns of referral, receipt, and completion of chemotherapy among older women at high risk of recurrence.

Patients and Methods A total of 2,124 women age 65 years or older who were diagnosed with early-stage breast cancer between 1990 and 1994 and 1996 to 1999 were included; 1,090 of these were at high risk of recurrence. We reviewed medical records to categorize chemotherapy outcomes as follows: did not discuss or were not referred to a medical oncologist (n = 133); discussed and/or referred to a medical oncologist but received no chemotherapy (n = 742); received an incomplete chemotherapy course (n = 29), or received a completed chemotherapy course (n = 186).

Results Overall, 19.7% of high-risk women received any chemotherapy, and 86.5% of these women completed their chemotherapy courses. Just greater than 10% of high-risk women did not have a discussion about chemotherapy as part of breast cancer treatment documented in the medical record; these women also received fewer diagnostic assessments of their initial tumors.

Conclusion Individuals who receive chemotherapy for early-stage breast cancer are a select subgroup of patients at high risk of recurrence. This study identifies characteristics of women who were referred for and who received chemotherapy, and this study plays an important role in understanding generalizability of studies that examine chemotherapy treatment effectiveness. Outcomes after breast cancer could continue to be improved with increased receipt of chemotherapy among older women at high risk of breast cancer recurrence.

Supported by Grant No. CRTG-03-024-01-CCE from the American Cancer Society (D.S.M.B.) and by Grant No. R01 CA093772 from the National Cancer Institute (R.A.S.).

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				A Ahmed, G Turner, B King, L Jones, D Culliford, D McCance, J Ardill, B T Johnston, G Poston, M Rees, et al. Midgut neuroendocrine tumours with liver metastases: results of the UKINETS study Endocr. Relat. Cancer, September 1, 2009; 16(3): 885 - 894. [Abstract] [Full Text] [PDF]