Octogenarians: Noncompliance with breast cancer treatment recommendations

Abstract

Recent research suggests that women older than 70 years of age with early breast cancer who choose lumpectomy may forgo radiation if they take antihormonal medication. However, many elderly patients choose to forgo both radiation and hormonal therapy. This study assessed treatment compliance in elderly patients with breast cancer. A retrospective review was conducted of patients with new-onset breast cancer older than 70 years of age. Patients were stratified by age (70 to 79 vs 80 years or older) and surgical procedure (lumpectomy vs mastectomy). Ninety-seven patients were included; 47 were aged 70 to 79 years, whereas 50 were aged 80 years or older. Treatment recommendations were similar between age groups; however, patients aged 80 years or older were more often noncompliant with recommendations for surgery (14.9 vs 0.0%, P = 0.012), radiation therapy (64.0 vs 16.0%, P = 0.001), and hormonal therapy (53.3 vs 22.6%, P = 0.013). When stratified according to surgical procedure, women aged 80 years or older receiving lumpectomy were overall more noncompliant (50.0 vs 14.8%, P = 0.014) than younger women. Women older than 80 years of age who elected for lumpectomy treatment were significantly less likely to receive standard recommendations of adjuvant hormonal or radiation therapy. The reasons for this vary and it is unknown whether this impacts their local recurrence or survival rate.