Title

Adjuvant tamoxifen prescription in women 65 years and older with primary breast cancer

UMMS Affiliation

Meyers Primary Care Institute; Department of Medicine, Division of Geriatric Medicine

Publication Date

6-1-2002

Document Type

Article

Subjects

Age Factors; Aged; Aged, 80 and over; Antineoplastic Agents, Hormonal; Breast Neoplasms; Chemotherapy, Adjuvant; Female; Humans; Logistic Models; Neoplasm Staging; *Patient Selection; *Physician's Practice Patterns; Physician-Patient Relations; Receptors, Estrogen; Tamoxifen; Tumor Markers, Biological; United States

Disciplines

Health Services Research | Primary Care

Abstract

PURPOSE: We examined patterns of adjuvant tamoxifen discussion and prescription among breast cancer patients age 65 years and older.

METHODS: We selected from women diagnosed with primary breast cancer those with (1) stage I (tumor diameter > or = 1 cm), stage II, or stage IIIa disease; (2) age 65 years or older on the date of diagnosis; and (3) permission from the attending physician to contact. Data were collected from consenting patients' medical records, telephone interviews with patients, and mailed questionnaires completed by their physicians.

RESULTS: We obtained medical record and interview data for 698 patients. The oldest patients (odds ratio [OR], 0.45; 95% confidence interval [CI], 0.23 to 0.87 for those aged 80+ relative to those aged 65 to 69 years old), those with more comorbid conditions (each additional comorbid condition reduced the odds of discussion by 0.84; 95% CI, 0.73 to 0.96), and those who were estrogen receptor-negative (OR, 0.56; 95% CI, 0.32 to 0.99) were less likely to report discussion of tamoxifen therapy with a physician. Older patients (OR, 2.17; 95% CI, 1.18 to 4.01 for 70- to 79-year-olds relative to 65- to 69-year-olds; OR, 2.44; 95% CI, 1.11 to 5.34 for those aged 80+ relative to those aged 65 to 69 years old), those who reported a greater influence of information about tamoxifen on decision-making (an increase in 1 SD increased the odds by 7.43; 95% CI, 4.36 to 12.65), and those whose physicians believed that the benefits of tamoxifen outweighed its risks (an increase in 1 SD increased the odds by 1.87; 95% CI, 1.34 to 2.62) were more likely to be prescribed tamoxifen.

CONCLUSION: These findings highlight the key role of communication in the care of older women with breast cancer and its ultimate influence on the receipt of therapy.

DOI of Published Version

10.1200/JCO.2002.08.137

Source

J Clin Oncol. 2002 Jun 1;20(11):2680-8. doi: 10.1200/JCO.2002.08.137

Journal/Book/Conference Title

Journal of clinical oncology : official journal of the American Society of Clinical Oncology

Related Resources

Link to Article in PubMed

PubMed ID

12039930