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首页> 外文期刊>Journal of geriatric oncology >Does life expectancy affect treatment of women aged 80 and older with early stage breast cancers?
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Does life expectancy affect treatment of women aged 80 and older with early stage breast cancers?

机译：预期寿命会影响80岁及以上患有早期乳腺癌的女性的治疗吗？

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Background: Data are needed on how life expectancy affects treatment decisions among women ≥ 80. years with early stage breast cancer. Methods: We used the linked Surveillance Epidemiology and End Results-Medicare claims dataset from 1992 to 2005 to identify women aged ≥ 80 newly diagnosed with lymph node negative, estrogen receptor positive tumors, ≤ 5. cm. To estimate life expectancy, we matched these women to women of similar age, region, and insurance, not diagnosed with breast cancer. We examined 5-year mortality of matched controls by illness burden (measured with the Charlson Comorbidity Index [CCI]) using Kaplan-Meier statistics. We examined treatments received by estimated life expectancy within CCI levels. We further examined factors associated with receipt of radiotherapy after breast conserving surgery (BCS). Results: Of 9,932 women, 39.6% underwent mastectomy, 30.4% received BCS plus radiotherapy, and 30.0% received BCS alone. Estimated 5-year mortality was 72% for women with CCIs of 3+, yet 38.0% of these women underwent mastectomy and 22.9% received radiotherapy after BCS. Conversely, estimated 5-year mortality was 36% for women with CCIs of 0 and 26.6% received BCS alone. Age 80-84, urban residence, higher grade, recent diagnosis, mammography use, and low comorbidity, were factors associated with receiving radiotherapy after BCS. Among women with CCIs of 3. + treated with BCS, 36.9% underwent radiotherapy. Conclusions: Many women aged ≥ 80 with limited life expectancies receive radiotherapy after BCS for treatment of early stage breast cancers while many in excellent health do not. More consideration needs to be given to patient life expectancy when considering breast cancer treatments.
机译：背景：需要数据来预测预期寿命如何影响≥80岁早期乳腺癌妇女的治疗决策。方法：我们使用1992年至2005年的“监测流行病学”和“最终结果-医疗保险”索赔数据集，对新诊断为淋巴结阴性，雌激素受体阳性，≤5 cm的≥80岁女性进行识别。为了估计预期寿命，我们将这些妇女与年龄，地区和保险相似但未诊断出患有乳腺癌的妇女进行了匹配。我们使用Kaplan-Meier统计资料按疾病负担（通过Charlson合并症指数[CCI]测量）检查了匹配对照的5年死亡率。我们检查了按预期寿命在CCI水平内接受的治疗。我们进一步检查了与保乳手术（BCS）后接受放疗相关的因素。结果：在9,932名妇女中，有39.6％接受了乳房切除术，30.4％接受了BCS加放疗，30.0％接受了BCS。 CCI为3+的女性的5年死亡率估计为72％，但其中38.0％的女性接受了乳房切除术，而22.9％的女性接受了BCS放疗。相反，估计CCI为0的女性5年死亡率为36％，仅接受BCS的女性为26.6％。 BCS后接受放疗的相关因素是80-84岁，城市居住，较高的等级，最近的诊断，使用乳房X线照相术和合并症低。在接受BCS治疗的CCI为3 +的女性中，有36.9％接受了放疗。结论：许多年龄≥80岁且预期寿命有限的妇女在BCS后接受放疗以治疗早期乳腺癌，而许多健康状况良好的妇女则没有。在考虑乳腺癌治疗时，需要更多考虑患者的预期寿命。

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