Between ages 69 and 70, there is a decline in adjuvant therapy recommendations for early breast cancer, according to a study published in the International Journal of Radiation Oncology, Biology, Physics. Wesley J. Talcott, MD, and colleagues identified two cohorts with strong indications for adjuvant treatment, regardless of age, who underwent lumpectomy for early-stage breast cancer between 2004 and 2017. Patients in cohort 1 (N=160,990) had higher-risk features and were appropriate for radiation. Those in cohort 2 (N=394,946) had hormone receptor positivity with tumors greater than 5 mm and were appropriate for endocrine therapy. The radiation recommendation among cohort 1 declined sharply at age 70, from 90% to 92% for those aged 50-69 to 81% for those aged 70. At age 70 versus 69 only, year-over-year age difference was an independent predictor of adjuvant radiation recommendation (OR, 0.47). A small decline in endocrine therapy recommendation was seen at age 70 for cohort 2, with year-over-year age difference a predictor of endocrine therapy recommendation at age 70 versus 69 only (OR, 0.86).
