Discrepancy between Consensus Recommendations and Actual Community Use of Adjuvant Chemotherapy in Women with Breast Cancer

摘要: Although the efficacy of chemotherapy in prolonging survival for women with breast cancer has been well documented (1–12), limited population-based information is available on actual use chemotherapy. Some hospital-based surveys have examined (13–15), but completeness questioned because frequently administered outpatient settings. The evolution recommendations about adjuvant early illustrated by National Institutes Health (NIH) consensus development conferences (1, 3, 12). In 1985, conference recommended premenopausal lymph node–positive (1). By 1990, both and postmenopausal confined to poor prognostic features, such as large size or negative hormone receptor status (3). The 2000 extended recommendation node-positive tumors node-negative greater than 1 cm size, regardless (12). Because from clinical trials 70 years age older, none made specific that group, other invoke individual decisions based circumstances patient preferences. We recently reported 65 older using Surveillance, Epidemiology, End Results (SEER) tumor registry data linked Medicare (16, 17). As expected, sharply decreased age, higher-stage, larger, estrogen receptor–negative were more likely receive 17). We review residing New Mexico who 20 received a diagnosis between 1991 1997. hypothesized would not vary younger characteristics which generally recommended. Furthermore, we highest (<45 age) among had no clear made.