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July 16, 2020

The Conundrum of the Association of Chemotherapy With Survival Outcomes Among Elderly Patients With Curable Luminal Breast Cancer

Author Affiliations
  • 1Department of Medicine–Breast Unit, The Royal Marsden National Health Service Foundation Trust, Sutton, Surrey, United Kingdom
  • 2“Sandro Pitigliani” Medical Oncology Department, Hospital of Prato, Prato, Italy
JAMA Oncol. Published online July 16, 2020. doi:10.1001/jamaoncol.2020.2194

Age is the most relevant risk factor for breast cancer, and almost half of breast cancer cases in the US are diagnosed in women older than 70 years.1 However, elderly adults are a heterogeneous population characterized by considerable differences in biological age, function, burden of comorbidities, cognition, nutritional status, psychosocial problems, and social support. Moreover, elderly adults are frequently excluded from therapeutic clinical trials, which explains the substantial lack of validated, empirical evidence to guide management of breast cancer in this specific age group. These issues pose a challenge for practitioners, especially in the context of curative treatment decisions. Comorbidities may substantially influence therapeutic decisions in elderly patients with breast cancer in view of competing risks of death, reduced functional reserve, impaired organ function, and higher risk of toxic effects.2

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