Breast Cancer Research and Treatment

, Volume 102, Issue 2, pp 227–236 | Cite as

Effect of undertreatment on the disparity in age-related breast cancer-specific survival among older women

  • Cynthia Owusu
  • Timothy L. Lash
  • Rebecca A. Silliman
Original paper

Abstract

Objectives

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.

Keywords

Breast cancer Older women Patterns␣of␣care Breast cancer-specific survival Undertreatment 

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Copyright information

© Springer Science+Business Media B.V. 2006

Authors and Affiliations

  • Cynthia Owusu
    • 1
    • 2
  • Timothy L. Lash
    • 2
    • 3
  • Rebecca A. Silliman
    • 2
    • 3
  1. 1.Hematology and Medical Oncology Section, Department of MedicineBoston University School of MedicineBostonUSA
  2. 2.Geriatrics Section, Department of MedicineBoston University School of MedicineBostonUSA
  3. 3.Department of EpidemiologyBoston University School of Public HealthBostonUSA

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