Skip to main content
Journal cover image

Adjuvant chemotherapy in older and younger women with lymph node-positive breast cancer.

Publication ,  Journal Article
Muss, HB; Woolf, S; Berry, D; Cirrincione, C; Weiss, RB; Budman, D; Wood, WC; Henderson, IC; Hudis, C; Winer, E; Cohen, H; Wheeler, J ...
Published in: JAMA
March 2, 2005

CONTEXT: Adjuvant chemotherapy improves survival for patients with local-regional breast cancer, but healthy older patients at high risk of recurrence are frequently not offered adjuvant chemotherapy, and the benefit of adjuvant chemotherapy in older patients is uncertain. OBJECTIVE: To compare the benefits and toxic effects of adjuvant chemotherapy among breast cancer patients in age groups of 50 years or younger, 51 to 64 years, and 65 years or older. DESIGN AND SETTING: Retrospective review of data from 4 randomized trials that accrued patients from academic and community medical centers between 1975 and 1999. Median follow-up for all patients was 9.6 years. All trials randomized patients to different regimens, doses, schedules, and durations of chemotherapy and all had a treatment arm with doses or schedules that were regarded to be "high" and potentially more toxic. PATIENTS: A total of 6487 women with lymph node-positive breast cancer; 542 (8%) patients were 65 years or older and 159 (2%) were 70 years or older. MAIN OUTCOME MEASURE: Comparison of disease-free survival, overall survival, and treatment-related mortality among different age groups. RESULTS: Multivariate analysis showed that smaller tumor size, fewer positive lymph nodes, more chemotherapy, and tamoxifen use were all significantly (P<.001) related to longer disease-free and overall survival. There was no association between age and disease-free survival. Overall survival was significantly (P<.001) worse for patients aged 65 or older because of death from causes other than breast cancer. Thirty-three deaths (0.5% of all patients) were attributed to treatment, and older women had higher treatment-related mortality. Older women and younger women derived similar reductions in breast cancer mortality and recurrence from regimens containing more chemotherapy. CONCLUSION: Age alone should not be a contraindication to the use of optimal chemotherapy regimens in older women who are in good general health.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

JAMA

DOI

EISSN

1538-3598

Publication Date

March 2, 2005

Volume

293

Issue

9

Start / End Page

1073 / 1081

Location

United States

Related Subject Headings

  • Survival Analysis
  • Risk Assessment
  • Retrospective Studies
  • Randomized Controlled Trials as Topic
  • Multivariate Analysis
  • Middle Aged
  • Lymphatic Metastasis
  • Humans
  • General & Internal Medicine
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Muss, H. B., Woolf, S., Berry, D., Cirrincione, C., Weiss, R. B., Budman, D., … Cancer and Leukemia Group B, . (2005). Adjuvant chemotherapy in older and younger women with lymph node-positive breast cancer. JAMA, 293(9), 1073–1081. https://doi.org/10.1001/jama.293.9.1073
Muss, Hyman B., Susan Woolf, Donald Berry, Constance Cirrincione, Raymond B. Weiss, Daniel Budman, William C. Wood, et al. “Adjuvant chemotherapy in older and younger women with lymph node-positive breast cancer.JAMA 293, no. 9 (March 2, 2005): 1073–81. https://doi.org/10.1001/jama.293.9.1073.
Muss HB, Woolf S, Berry D, Cirrincione C, Weiss RB, Budman D, et al. Adjuvant chemotherapy in older and younger women with lymph node-positive breast cancer. JAMA. 2005 Mar 2;293(9):1073–81.
Muss, Hyman B., et al. “Adjuvant chemotherapy in older and younger women with lymph node-positive breast cancer.JAMA, vol. 293, no. 9, Mar. 2005, pp. 1073–81. Pubmed, doi:10.1001/jama.293.9.1073.
Muss HB, Woolf S, Berry D, Cirrincione C, Weiss RB, Budman D, Wood WC, Henderson IC, Hudis C, Winer E, Cohen H, Wheeler J, Norton L, Cancer and Leukemia Group B. Adjuvant chemotherapy in older and younger women with lymph node-positive breast cancer. JAMA. 2005 Mar 2;293(9):1073–1081.
Journal cover image

Published In

JAMA

DOI

EISSN

1538-3598

Publication Date

March 2, 2005

Volume

293

Issue

9

Start / End Page

1073 / 1081

Location

United States

Related Subject Headings

  • Survival Analysis
  • Risk Assessment
  • Retrospective Studies
  • Randomized Controlled Trials as Topic
  • Multivariate Analysis
  • Middle Aged
  • Lymphatic Metastasis
  • Humans
  • General & Internal Medicine
  • Female