Patterns of breast carcinoma treatment in older women: Patient preference and clinical and physician influences

摘要: BACKGROUND Older women have high rates of breast carcinoma, and there are substantial variations in the patterns care for this population group. METHODS The authors studied 718 carcinoma patients age 67 years older who were diagnosed with localized disease between 1995 1997 from 29 hospitals 5 regions. Data collected patients, charts, surgeons. Logistic regression analysis was used to evaluate determinants treatment. RESULTS Women concerned about body image 1.8 times more likely (95% confidence interval [95% CI], 1.1–2.8) receive conservation surgery radiotherapy than without preference, controlling other factors. In contrast, preferred receiving no therapy beyond 3.9 CI, 2.9–6.1) undergo mastectomy women, after considering Radiotherapy omitted 3.4 often 2.0–5.6) among 80 ages 67–79 years, covariates. Black tended 2.0 0.9–4.4) white (P = 0.09). Women also 70% less (odds ratio 0.3; 95% 0.1–0.8) chemotherapy health, functional status, covariates. CONCLUSIONS After factors, patient preferences found be associated treatment women. Further research training needed provide growing that is both clinically appropriate consonant a woman's preferences. Cancer 2000;89:561–73. © 2000 American Society.