title: Febrile neutropaenia and chemotherapy discontinuation in women aged 70 years or older receiving adjuvant chemotherapy for early breast cancer.
abstract: OBJECTIVE
  Low rates of adjuvant chemotherapy use are frequently reported in older women with early breast cancer. One of the reasons for this may be the risk of febrile neutropaenia or the perception that older patients will probably not complete the chemotherapy course prescribed. There are no data regarding these adverse outcomes in routine clinical practice.
  
  
  METHODS
  We identified 128 patients aged 70 years or over who received neoadjuvant or adjuvant chemotherapy for early breast cancer in seven UK cancer centres between 2006 and 2012. Data were collected regarding standard clinical and pathological variables and treatment toxicity and outcomes.
  
  
  RESULTS
  Twenty-four patients (19%) had an episode of febrile neutropaenia. Overall, 27 patients (21%) did not complete their planned therapy. Chemotherapy discontinuation was more common in those patients with an episode of febrile neutropaenia (46% versus 16%, P = 0.004). Thirty patients (23%) were admitted with chemotherapy-related complications. There were no treatment-related deaths.
  
  
  CONCLUSIONS
  The rates of febrile neutropaenia and treatment discontinuation are high in women aged 70 years or over receiving adjuvant chemotherapy for breast cancer. Close attention should be paid to the choice or regimen and the use of supportive therapies in this patient population.
authors.affiliation: Sussex Cancer Centre, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK.
authors.forename: D
authors.initials: D
authors.lastname: Adjogatse
authors.affiliation: Royal Marsden NHS Foundation Trust, London and Sutton, UK.
authors.forename: E
authors.initials: E
authors.lastname: Thanopoulou
authors.affiliation: Maidstone and Tunbridge Wells NHS Trust, Maidstone, UK.
authors.forename: A
authors.initials: A
authors.lastname: Okines
authors.affiliation: Guys and St Thomas' NHS Foundation Trust, London, UK.
authors.forename: K
authors.initials: K
authors.lastname: Thillai
authors.affiliation: Sussex Cancer Centre, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK.
authors.forename: F
authors.initials: F
authors.lastname: Tasker
authors.affiliation: Royal Marsden NHS Foundation Trust, London and Sutton, UK.
authors.forename: S R D
authors.initials: SR
authors.lastname: Johnston
authors.affiliation: Maidstone and Tunbridge Wells NHS Trust, Maidstone, UK.
authors.forename: C
authors.initials: C
authors.lastname: Harper-Wynne
authors.affiliation: Royal Marsden NHS Foundation Trust, London and Sutton, UK.
authors.forename: E
authors.initials: E
authors.lastname: Torrisi
authors.affiliation: Sussex Cancer Centre, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK; Royal Marsden NHS Foundation Trust, London and Sutton, UK. Electronic address: Alistair.ring@rmh.nhs.uk.
authors.forename: A
authors.initials: A
authors.lastname: Ring
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D018275:Carcinoma, Lobular / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D017024:Chemotherapy, Adjuvant; D064147:Febrile Neutropenia / Q000139:chemically induced*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020360:Neoadjuvant Therapy / Q000009:adverse effects*; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D010349:Patient Compliance; D011379:Prognosis; D015996:Survival Rate
keywords: Adjuvant; breast cancer; neutropaenia; toxicity