Xianglin L. Du, MD, PhD; Charles R. Key, MD, PhD; Cynthia Osborne, MD; Jonathan D. Mahnken, MS; James S. Goodwin, MD
Du XL, Key CR, Osborne C, Mahnken JD, Goodwin JS. Discrepancy between Consensus Recommendations and Actual Community Use of Adjuvant Chemotherapy in Women with Breast Cancer. Ann Intern Med. 2003;138:90-97. doi: 10.7326/0003-4819-138-2-200301210-00009
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Published: Ann Intern Med. 2003;138(2):90-97.
National Institutes of Health consensus guidelines recommend adjuvant chemotherapy for premenopausal or postmenopausal women with node-positive tumors or node-negative breast tumors greater than 1 cm, regardless of hormone receptor status. The actual (and age-specific) use of chemotherapy in women with breast cancer is unknown.
Using data from the New Mexico Tumor Registry, these investigators show that chemotherapy is used much less frequently than recommended and that frequency decreases sharply with advancing age.
Since only a minority of postmenopausal women receive adequate treatment for breast cancer, many unnecessary deaths could probably be prevented by following the National Institutes of Health guidelines.
Women with stage I, stage II, or stage IIIA breast cancer are categorized into two groups based on their tumor characteristics—characteristics for which the 1990 National Institute of Health (NIH) Consensus Conference generally recommended chemotherapy ( = 2486; ) and characteristics for which the consensus conference recommended decisions on an individual, discretionary basis ( = 2615; ). The 2000 NIH Consensus Conference recommended chemotherapy for all breast tumors 1.0 cm or larger in size; however, these recommendations were made after we conducted our study. For women 70 to 74 years of age and women 75 years of age and older, the NIH Consensus Conference made no specific consensus recommendations on treatment with chemotherapy.
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Hematology/Oncology, Breast Cancer.
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