Slight Differences in Patient Age May Lead to Different Treatment Recommendations in Early-Stage Breast Cancer

By: Sarah Lynch
Posted: Friday, April 28, 2023

Researchers have discovered and analyzed variance in breast cancer treatment attributable to patient age differences as small as 1 year. They hypothesized that age cutoffs may cause nonevidence–based adjuvant treatment allocation in patients with early-stage disease. Wesley J. Talcott, MD, MBA, of Yale School of Medicine, New Haven, Connecticut, and colleagues presented their study findings on this “unique decline in appropriate adjuvant therapy recommendation between the ages of 69 and 70” in the International Journal of Radiation Oncology • Biology • Physics.

“Our study indicates that physicians should be mindful of how we factor age into treatment decisions and adopt a more nuanced approach, extending beyond defining patients as simply ‘young’ or ‘elderly,’” stated Dr. Talcott in an American Society for Radiation Oncology (ASTRO) press release.

The researchers studied two cohorts of patients who underwent lumpectomy for early-stage breast cancer between 2004 and 2017 within the National Cancer Database. The cohorts differed in risk factors, which led to radiation being the preferred course of treatment for the first group and endocrine therapy for the second. Multivariable logistic regressions with odds ratios and 99.8% confidence intervals were performed to examine whether a single-year difference in patient age was associated with a difference in adjuvant therapy recommendation.

Recommendations for radiation therapy decreased sharply by about 10% at age 70 within the first group, and multivariable logistic regressions showed that age was an independent predictor for adjuvant radiation therapy recommendations at age 70 versus age 69. In the second group, there was a slight decline in recommendations for endocrine therapy at age 70. Similarly, age was a predictor of endocrine therapy recommendation at age 70 versus age 69. The researchers acknowledged that their study is the first to describe this phenomenon in the treatment of breast cancer and that it should promote the idea of case-by-case treatment rather than dividing patients into age categories.

Disclosure: For full disclosures of the study authors, visit redjournal.org.

International Journal of Radiation Oncology • Biology • Physics