To the Editor.—
The changing age pattern of the effect of a positive family history on the incidence of breast cancer as described by Roseman et al in the January 1990 issue of the Archives1 can also be seen in another phenomenon related to this disease, ie, chemotherapy responsiveness. When comparing the survival percentages of patients treated with cyclophosphamide, methotrexate, and fluorouracil with the percentages of untreated patients,2 the effect of the adjuvant chemotherapy appears to diminish with increasing patients' age.3 In patients presenting and treated in the fourth decade of their life, the survival benefit as compared with that in untreated patients after 3 years' and 12 years' follow-up ranges from 15% to 33%, respectively. In the fifth decade, the treatment effect ranges from — 5% to 12%. In the sixth decade, the largest differences were found at 3 years' follow-up, ie, 22%, decreasing steadily to
Cohen P. A Positive Family History of Breast Cancer and Benign Breast Disease: Does Its Effect Diminish With Age? Arch Intern Med. 1991;151(2):402–404. doi:10.1001/archinte.1991.00400020136033
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