Observational studyCancer medicine2020
Delayed initiation of adjuvant chemotherapy in older women with breast cancer.
Observational study in Cancer medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- Frequency of use and characterization of frailty assessments in observational studies on older women with breast cancer: a systematic review.BMC geriatrics · 2024Pooled it
- Effect of Surgical Delay After Neoadjuvant Chemotherapy on Survival Outcomes in Breast Cancer: A Systematic Review and Meta-Analysis.European journal of breast health · 2026Article
- Patterns of care and treatment delays among patients with early-stage breast cancer: long term impact of the COVID-19 (C19) pandemic.Cancer causes & control : CCC · 2025Article
- Cost-effectiveness analysis of gene-expression-based prognostic tests for patients with early-stage breast cancer in South Korea.Cost effectiveness and resource allocation : C/E · 2025Article
- Geospatial disparities, health system factors, and breast cancer care quality.JNCI cancer spectrum · 2025Article
- Sequence of therapy impact on older women with comorbidities and triple-negative or HER2-positive breast cancer.NPJ breast cancer · 2025Review
- Regional differences in neo/adjuvant chemotherapy timing in patients with early-stage triple-negative breast cancer in England.Breast cancer research and treatment · 2025Article
- Socioeconomic status and delayed breast cancer care in Southeast Texas: a retrospective cohort study.Proceedings (Baylor University. Medical Center) · 2025Article
- Mastectomy, HER2 Receptor Positivity, NPI, Late Stage and Luminal B-Type Tumor as Poor Prognostic Factors in Geriatric Patients with Breast Cancer.Diagnostics (Basel, Switzerland) · 2024Article
- African American and Hispanic Cancer Survivors' and Caregivers' Experiences in Nebraska.Journal of immigrant and minority health · 2024Article
- Multicenter Study on Breast Cancer in the Geriatric Population: Insights for Effective Treatment Strategies.Cureus · 2024Article
- Oncoplastic Breast Reduction: A Systematic Review of Postoperative Complications.Plastic and reconstructive surgery. Global open · 2023Article
- Medicaid expansion is associated with treatment receipt, timeliness, and outcomes among young adults with breast cancer.JNCI cancer spectrum · 2023Article
- Medicaid expansion, chemotherapy delays, and racial disparities among women with early-stage breast cancer.Journal of the National Cancer Institute · 2023Article
- Adjuvant chemotherapy non-adherence, patient-centered communication, and patient-level factors in elderly breast and colon cancer patients.Cancer medicine · 2023Article
- Disparities in timely treatment among young women with breast cancer.American journal of surgery · 2022Article
- Gaps in completion and timeliness of breast surgery and adjuvant therapy: a retrospective cohort of Haitian patients with nonmetastatic breast cancer.Breast cancer research and treatment · 2022Article
- Exploring and supporting older women's chemotherapy decision-making in early-stage breast cancer.Journal of geriatric oncology · 2022Article
- Adjuvant Treatment of Elderly Breast Cancer Patients: Offer the Best Chances of Cure.Breast care (Basel, Switzerland) · 2022Review
- Breast Cancer in Geriatric Patients: Current Landscape and Future Prospects.Clinical interventions in aging · 2022Review
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
backgroundAdjuvant chemotherapy benefits early-stage breast cancer (BC) patients. Older women receive guideline-adherent treatment less frequently and experience treatment delays more frequently. We evaluated factors associated with delaying adjuvant chemotherapy and the delays' survival impact in a large population-based cohort of elderly BC patients.
methodsPatients age >66 years diagnosed 2001-2015 with localized or regional BC were identified in the SEER-Medicare and Texas Cancer Registry-Medicare databases. Time from surgery to chemotherapy (TTC) was categorized into four groups: 0-30, 31-60, 61-90, and >90 days. We identified predictors of delays, estimated overall (OS) and BC-specific (BCSS) survival, and determined the association between TTC and outcome adjusting for other variables.
resultsAmong 28,968 women (median age 71 years), median TTC was 43 days. 10.7% of patients experienced TTC >90 days. Older age, Black or Hispanic race/ethnicity, unmarried status, more comorbidities, hormone receptor-positivity, mastectomy, Oncotype DX testing, and full state buy-in were associated with increased risk of delay. Five-year OS estimates by TTC group were 0.82, 0.81, 0.80, and 0.74, respectively (p<.001). BCSS demonstrated a similar trend (p<.001). Chemotherapy delay was associated with worse OS (HR=1.33, 95%CI 1.25-1.40) and BCSS (HR=1.39, 95%CI 1.27-1.53). In subgroup analysis, delayed chemotherapy was associated with worse OS and BCSS among patients with hormone receptor-positive (HR=1.56, 95%CI 0.97-2.51), HER2-positive (HR=1.99, 95%CI 1.04-3.79), and triple-negative (HR=2.15, 95%CI 1.38-3.36) tumors.
conclusionChemotherapy delays are associated with worse survival in older BC patients. Providers should avoid delays and initiate chemotherapy ≤90 days after surgery regardless of patients' BC subtype or age.
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