PT  - JOURNAL ARTICLE
AU  - KUMI NIGUMA
AU  - KANAKO MAMISHIN
AU  - YOICHI NAITO
AU  - SHOGO NOMURA
AU  - MASASHI WAKABAYASHI
AU  - SHOTA KUSUHARA
AU  - CHIKAKO FUNASAKA
AU  - TAKEHIRO NAKAO
AU  - YOKO FUKASAWA
AU  - CHIHIRO KONDOH
AU  - KENICHI HARANO
AU  - TAKAHIRO KOGAWA
AU  - NOBUAKI MATSUBARA
AU  - AKO HOSONO
AU  - TATSUYA ONISHI
AU  - TOSHIKATSU KAWASAKI
AU  - TORU MUKOHARA
TI  - Impact of Older Age and Medico-social Factors on the Decision to Offer Adjuvant Chemotherapy to Patients With Breast Cancer
AID  - 10.21873/anticanres.15864
DP  - 2022 Jul 01
TA  - Anticancer Research
PG  - 3743--3751
VI  - 42
IP  - 7
4099  - http://ar.iiarjournals.org/content/42/7/3743.short
4100  - http://ar.iiarjournals.org/content/42/7/3743.full
SO  - Anticancer Res2022 Jul 01; 42
AB  - Background/Aim: Although clinicians are expected to set a higher threshold for administering adjuvant chemotherapy to older than younger patients with breast cancer, the extent to which older patients are less likely to be offered adjuvant chemotherapy and the medico-social factors that influence decision-making are unclear. Patients and Methods: We retrospectively evaluated the correlations of clinicopathological factors, including age (≥75 years vs. <75 years), for all candidates for adjuvant chemotherapy, and of additional medico-social factors, including the number of family members living together, for older patients, with the rate of referral from breast surgeons to medical oncologists. Results: Among 872 candidates for adjuvant chemotherapy, age ≥75 years was significantly correlated with a lower referral rate (24 % vs. 44%, p<0.001). In the analysis by age group, we did not identify specific medicosocial factors that were differentially emphasized, but older patients who lived with ≥2 other family members tended not to be referred to a medical oncologist compared to those who lived alone or with one family member (1/23 vs. 15/47). Although 5 of 22 older patients (23%) who were referred to a medical oncologist actually received adjuvant chemotherapy (vs. 60% of younger patients), all needed treatment modifications. Conclusion: Breast surgeons regard age ≥75 years as a key factor for avoiding adjuvant chemotherapy but they also consider similar medico-social factors irrespective of the patient’s age regarding the decision to refer patients to medical oncologists.