Related Experiment Video
Updated: May 22, 2025
Evaluating the Effectiveness of Cancer Drug Sensitization In Vitro and In Vivo
Published on: February 6, 2015
Does Undertreatment With Chemotherapy Impact the Outcomes of Elderly Patients With Early-Stage Breast Cancer? A
Jéssica Monteiro Vasconcellos1, Renata Colombo Bonadio2, Sofia Vidaurre Mendes1
1Instituto do Câncer do Estado de São Paulo, Universidade de São Paulo, São Paulo, Brazil.
Background:
The management of breast cancer (BC) in elderly patients remains a topic of debate among specialists, with concerns regarding potential undertreatment. This study aimed to evaluate the impact of undertreatment on outcomes in older patients with early-stage BC.
Methods:
This retrospective cohort study analyzed patients aged over 70 years with early breast cancer who were treated at an academic cancer center between 2009 and 2021.Indications for (neo)adjuvant chemotherapy (CT) were assessed based on institutional guidelines. Undertreatment was defined as patients who had an indication for CT but did not receive it. The study evaluated undertreatment rate, recurrence rate, disease-free survival, breast cancer-specific survival (BCSS), overall survival (OS), and prognostic factors.
Results:
A total of 1455 patients had early-stage BC. The majority of patients were between 70 and 80 years old (71%), had luminal tumors (79%), and mild comorbidities (60%). Of the 921 patients for whom (neo)adjuvant chemotherapy (CT) was indicated, 57% did not receive it, mainly due to age and comorbidities. The 5-year BCSS was 90.3% in the undertreated group compared to 86.3% in the CT group (P = .024). The 5-year OS was 76.3% in the undertreated group compared to 81% in the CT group (P = .389). Multivariable analysis identified predictors of worse OS, but undertreatment was not directly associated.
Conclusion:
Undertreatment rates were high in this older population, yet outcomes were not negatively impacted. Thus, not offering (neo)adjuvant CT may be a wise choice for selected elderly pts with early BC, taking into account their comorbidities and functional status.
More Related Videos
06:46Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery
Published on: September 27, 2024
08:57Sample Extraction and Simultaneous Chromatographic Quantitation of Doxorubicin and Mitomycin C Following Drug Combination Delivery in Nanoparticles to Tumor-bearing Mice
Published on: October 5, 2017
Related Concept Videos
01:21Cancer Survival Analysis
02:49Cancer Therapies
However, cancer treatments can pose several challenges, as therapies used to kill cancer cells are generally also toxic to normal cells. Moreover, cancer cells mutate rapidly and can develop resistance to chemical agents or radiation therapy. Besides, all types of cancer cells may not respond to the same therapy. Some cancer cells respond to one...
02:57Targeted Cancer Therapies
There are several types of targeted therapies against...
01:27Nursing Ethical Principles II
Consider the following scenario, which illustrates how these principles are applied in the care of Mr. John, a fifty-year-old teacher diagnosed with metastatic liver cancer.
Initially, Mr. John's...
02:50Combination Therapies and Personalized Medicine
The combination of the drug acetazolamide and sulforaphane is a good example of combination therapy to treat cancer. The cells in the interior of a large tumor often die due to the hypoxic and...