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Selected research from leading health care experts whose findings have a direct bearing on public policies effecting medical progress. Research is chosen based on its quality and relevance by the Medical Progress Today editorial staff.

Selected Research

Adjuvant Chemotherapy in Older and Younger Women With Lymph Node–Positive Breast Cancer
Hyman B. Muss, M.D., The Journal of the American Medical Association, 3-2-05

There has been some concern that although “adjuvant chemotherapy improves survival for patients with local-regional breast cancer, 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.”

This study “compare[s] 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.” The researchers find that “smaller tumor size, fewer positive lymph nodes, more chemotherapy, and tamoxifen use were all significantly...related to longer disease-free and overall survival. There was no association between age and disease-free survival.”

However, “survival was significantly worse for patients aged 65 or older because of death from causes other than breast cancer. Thirty-three deaths…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.”

The researchers concluded that “age alone should not be a contraindication to the use of optimal chemotherapy regimens in older women who are in good general health.”



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