Comorbidities need routine consideration
December 07, 2011 at 3:19 PM
Age influences the risk of recurrence, and age and comorbidities significantly influence the risk of death without recurrence, according to an analysis of 6000 women with breast cancer, undertaken by Dr Alistair Ring, Senior Lecturer and Honorary Consultant in Oncology, and others.
The Arimidex, Tamoxifen Alone or in Combination (ATAC) study was a double-blind randomized trial in which postmenopausal women with early-stage breast cancer were assigned to receive anastrozole, tamoxifen, or the combination of both. The researchers conducted a retrospective analysis to examine the effects of comorbidities and age on treatment received, breast cancer–related mortality, and competing causes of mortality.
The 6184 person study of women patients a quarter of whom were aged over 70 years, suggested that the risk of death without reoccurrence increased significantly with the comorbidity score and therefore suggests that routine assessment of comorbidities should be incorporated into decisions regarding adjuvant therapies.
The paper concludes: “These data clearly demonstrate the impact of age, comorbidities, and competing causes of mortality in older women with breast cancer. Other components of the Comprehensive Geriatric Assessment, such as functional status, cognitive function, and physical fitness, may add additional prognostic information. It is recommended that formal evaluationof comorbidities is routinely incorporated into the decision making process regarding adjuvant therapies in older women with early breast cancer”.
Influence of Comorbidities and Age on Risk of Death Without Recurrence: A Retrospective Analysis of the Arimidex, Tamoxifen Alone or in Combination Trial; Alistair Ring, Ivana Sestak, Michael Baum, Anthony Howell, Aman Buzdar, Mitch Dowsett, John F. Forbes and Jack Cuzick
Journal of Clinical Oncology, Vol 29 No 32 4266-4272
View the paper at the Journal of Clinical Oncology website