Despite being more commonly diagnosed in women ages 40 or younger, an estimated 10% to 15% of early triple-negative breast cancer (TNBC) cases are diagnosed in patients over 70.
Current guidelines recommend the use of adjuvant chemotherapy in early-stage TNBC regardless of a patient's age; however, recent data published in JAMA Network Open indicated that underutilization of adjuvant chemotherapy may have contributed to worse outcomes in this patient population in the past.
"When we use these treatments for elderly patients it is a very well-known fact that most of the time we undertreat," said Ahmed Elkhanany, MD, of Baylor College of Medicine in Houston. "This may lead to a decrease in their outcomes compared with other patients."
The retrospective cohort study used data from the Surveillance, Epidemiology, and End Results database from 2010 to 2021 to evaluate breast-cancer specific survival of patients ages 70 or older who received chemotherapy compared with those who did not. The analysis included 5,730 women with nonmetastatic TNBC who underwent surgical removal of their cancer.
Of the total study population, 2,509 patients received chemotherapy and 3,221 did not. Compared with those who did not receive adjuvant chemotherapy, receipt of adjuvant chemotherapy was associated with about a 30% lower risk of death from breast cancer (HR 0.69, 95% CI 0.58-0.82) and a 45% lower risk for death overall (HR 0.55, 95% CI 0.49-0.62). Increasing age -- 80-89 years and 90 or older -- was associated with lower odds of receipt of adjuvant chemotherapy.
