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dc.contributor.authorSilliman, Rebecca A.
dc.contributor.authorGuadagnoli, Edward
dc.contributor.authorRakowski, William
dc.contributor.authorLandrum, Mary Beth
dc.contributor.authorLash, Timothy L.
dc.contributor.authorWolf, Robert
dc.contributor.authorFink, Aliza
dc.contributor.authorGanz, Patricia A.
dc.contributor.authorGurwitz, Jerry H.
dc.contributor.authorBorbas, Catherine
dc.contributor.authorMor, Vincent
dc.date2022-08-11T08:09:22.000
dc.date.accessioned2022-08-23T16:27:58Z
dc.date.available2022-08-23T16:27:58Z
dc.date.issued2002-06-01
dc.date.submitted2011-12-09
dc.identifier.citationJ Clin Oncol. 2002 Jun 1;20(11):2680-8. doi: 10.1200/JCO.2002.08.137
dc.identifier.issn0732-183X (Linking)
dc.identifier.doi10.1200/JCO.2002.08.137
dc.identifier.pmid12039930
dc.identifier.urihttp://hdl.handle.net/20.500.14038/36910
dc.description.abstractPURPOSE: We examined patterns of adjuvant tamoxifen discussion and prescription among breast cancer patients age 65 years and older. METHODS: We selected from women diagnosed with primary breast cancer those with (1) stage I (tumor diameter > or = 1 cm), stage II, or stage IIIa disease; (2) age 65 years or older on the date of diagnosis; and (3) permission from the attending physician to contact. Data were collected from consenting patients' medical records, telephone interviews with patients, and mailed questionnaires completed by their physicians. RESULTS: We obtained medical record and interview data for 698 patients. The oldest patients (odds ratio [OR], 0.45; 95% confidence interval [CI], 0.23 to 0.87 for those aged 80+ relative to those aged 65 to 69 years old), those with more comorbid conditions (each additional comorbid condition reduced the odds of discussion by 0.84; 95% CI, 0.73 to 0.96), and those who were estrogen receptor-negative (OR, 0.56; 95% CI, 0.32 to 0.99) were less likely to report discussion of tamoxifen therapy with a physician. Older patients (OR, 2.17; 95% CI, 1.18 to 4.01 for 70- to 79-year-olds relative to 65- to 69-year-olds; OR, 2.44; 95% CI, 1.11 to 5.34 for those aged 80+ relative to those aged 65 to 69 years old), those who reported a greater influence of information about tamoxifen on decision-making (an increase in 1 SD increased the odds by 7.43; 95% CI, 4.36 to 12.65), and those whose physicians believed that the benefits of tamoxifen outweighed its risks (an increase in 1 SD increased the odds by 1.87; 95% CI, 1.34 to 2.62) were more likely to be prescribed tamoxifen. CONCLUSION: These findings highlight the key role of communication in the care of older women with breast cancer and its ultimate influence on the receipt of therapy.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=12039930&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1200/JCO.2002.08.137
dc.subjectAge Factors
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectAntineoplastic Agents, Hormonal
dc.subjectBreast Neoplasms
dc.subjectChemotherapy, Adjuvant
dc.subjectFemale
dc.subjectHumans
dc.subjectLogistic Models
dc.subjectNeoplasm Staging
dc.subject*Patient Selection
dc.subject*Physician's Practice Patterns
dc.subjectPhysician-Patient Relations
dc.subjectReceptors, Estrogen
dc.subjectTamoxifen
dc.subjectTumor Markers, Biological
dc.subjectUnited States
dc.subjectHealth Services Research
dc.subjectPrimary Care
dc.titleAdjuvant tamoxifen prescription in women 65 years and older with primary breast cancer
dc.typeJournal Article
dc.source.journaltitleJournal of clinical oncology : official journal of the American Society of Clinical Oncology
dc.source.volume20
dc.source.issue11
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/meyers_pp/291
dc.identifier.contextkey2396651
html.description.abstract<p>PURPOSE: We examined patterns of adjuvant tamoxifen discussion and prescription among breast cancer patients age 65 years and older.</p> <p>METHODS: We selected from women diagnosed with primary breast cancer those with (1) stage I (tumor diameter > or = 1 cm), stage II, or stage IIIa disease; (2) age 65 years or older on the date of diagnosis; and (3) permission from the attending physician to contact. Data were collected from consenting patients' medical records, telephone interviews with patients, and mailed questionnaires completed by their physicians.</p> <p>RESULTS: We obtained medical record and interview data for 698 patients. The oldest patients (odds ratio [OR], 0.45; 95% confidence interval [CI], 0.23 to 0.87 for those aged 80+ relative to those aged 65 to 69 years old), those with more comorbid conditions (each additional comorbid condition reduced the odds of discussion by 0.84; 95% CI, 0.73 to 0.96), and those who were estrogen receptor-negative (OR, 0.56; 95% CI, 0.32 to 0.99) were less likely to report discussion of tamoxifen therapy with a physician. Older patients (OR, 2.17; 95% CI, 1.18 to 4.01 for 70- to 79-year-olds relative to 65- to 69-year-olds; OR, 2.44; 95% CI, 1.11 to 5.34 for those aged 80+ relative to those aged 65 to 69 years old), those who reported a greater influence of information about tamoxifen on decision-making (an increase in 1 SD increased the odds by 7.43; 95% CI, 4.36 to 12.65), and those whose physicians believed that the benefits of tamoxifen outweighed its risks (an increase in 1 SD increased the odds by 1.87; 95% CI, 1.34 to 2.62) were more likely to be prescribed tamoxifen.</p> <p>CONCLUSION: These findings highlight the key role of communication in the care of older women with breast cancer and its ultimate influence on the receipt of therapy.</p>
dc.identifier.submissionpathmeyers_pp/291
dc.contributor.departmentDepartment of Medicine, Division of Geriatric Medicine
dc.contributor.departmentMeyers Primary Care Institute
dc.source.pages2680-8


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