title: A retrospective study of the impact of age on patterns of care for elderly patients with metastatic breast cancer.
abstract: This study aims at evaluating the impact of age on patterns of care in elderly patients with metastatic breast cancer (MBC) and their outcome. We identified 177 patients aged ≥ 65 treated for MBC at the National Cancer Center Hospital in Japan from 1999 to 2007. We evaluated the impact of age on the selection of best supportive care (BSC) only, chemotherapy as first-line treatment, and chemotherapy after first-line endocrine therapy. Fisher's exact test and a multivariate logistic regression analysis with variables of age, performance status (PS), hormone receptor (HR) status, human epidermal growth factor-2 (HER2), and life-threatening disease (LTD) were used. The median age of patients was 72, and 60 patients (33.9%) were aged ≥ 75. HR-negative patients and those whose PS was ≥ 2, regardless of age, were more likely to choose BSC without chemotherapy. Multivariate analysis revealed age ≥ 75 (P = 0.018), positive-HR status (P < 0.001), and absence of LTD (P < 0.001) were significantly correlated to choose endocrine therapy rather than chemotherapy. In patients who had previous endocrine therapy, age (P = 0.008) and absence of HER2 (P = 0.018) were related not to choose chemotherapy. Not age but HR-negative status or PS ≥ 2 were related to the selection of BSC. In selecting endocrine therapy rather than chemotherapy, age (≥ 75), HR-positive, and absence of LTD were significant factors. In patients failed to endocrine therapy, age and HER2 status were correlated to decision-making to choose chemotherapy.
authors.affiliation: Breast and Medical Oncology Division, National Cancer Center Hospital, Chuo-ku, Tokyo, 104-0045, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Hashimoto
authors.forename: Kan
authors.initials: K
authors.lastname: Yonemori
authors.forename: Chikako
authors.initials: C
authors.lastname: Shimizu
authors.forename: Akihiro
authors.initials: A
authors.lastname: Hirakawa
authors.forename: Harukaze
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Makiko
authors.initials: M
authors.lastname: Ono
authors.forename: Taizo
authors.initials: T
authors.lastname: Hirata
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Kouno
authors.forename: Kenji
authors.initials: K
authors.lastname: Tamura
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Katsumata
authors.forename: Masashi
authors.initials: M
authors.lastname: Ando
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Fujiwara
mesh_terms: D000367:Age Factors; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D005260:Female; D005853:Geriatrics / Q000592:standards*; D006801:Humans; D009362:Neoplasm Metastasis; D010166:Palliative Care / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians'; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000235:genetics; D012189:Retrospective Studies
chemical_list: D000970:Antineoplastic Agents; D018719:Erb-b2 Receptor Tyrosine Kinases