Adjuvant tamoxifen prescription in women 65 years and older with primary breast cancer
Authors
Silliman, Rebecca A.Guadagnoli, Edward
Rakowski, William
Landrum, Mary Beth
Lash, Timothy L.
Wolf, Robert
Fink, Aliza
Ganz, Patricia A.
Gurwitz, Jerry H.
Borbas, Catherine
Mor, Vincent
UMass Chan Affiliations
Department of Medicine, Division of Geriatric MedicineMeyers Primary Care Institute
Document Type
Journal ArticlePublication Date
2002-06-01Keywords
Age FactorsAged
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
Health Services Research
Primary Care
Metadata
Show full item recordAbstract
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.Source
J Clin Oncol. 2002 Jun 1;20(11):2680-8. doi: 10.1200/JCO.2002.08.137DOI
10.1200/JCO.2002.08.137Permanent Link to this Item
http://hdl.handle.net/20.500.14038/36910PubMed ID
12039930Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1200/JCO.2002.08.137