Impact of patients´ age on chemotherapy indication for early breast cancer in Germany

Background Chemotherapy for early breast cancer (EBC) is used more specifically due to individual risk stratification. In cases with chemotherapy indication the neoadjuvant application (NACT) is the preferred option. It enables in vivo sensitivity testing and less radical surgery as compared to primary surgery and adjuvant chemotherapy (ACT). Patients’ age is one of the most relevant factors concerning decision-making in the context of chemotherapy. Intention of this study was to illustrate the impact of patients’ age on systemic treatment of EBC with data from a large patient cohort.

Methods The study analyzed chemotherapy use and time trends for patients with EBC treated at 104 German breast units between January 2008 and December 2017 in dependence of patients´ age (separated into six age cohorts). Data were obtained through a quality-controlled benchmarking process.

Results Altogether, 124,084 patients were included, of whom 46,279 (37.3%) received chemotherapy. For 44,765 of these cases, detailed information on systemic treatment and surgery were available. In that cohort, chemotherapy was administered as NACT in 14,783 patients (33.0%) and as ACT in 29,982 (67.0%) patients. Younger patients received chemotherapy more often, overall (≤29a: 74.2%; 30-39a: 71.3%) and as NACT (< 29a: 66.9%; 30-39a: 56.0%) in comparison to older patients regarding both, overall CHT (60-69a: 37.5%; ≥70a: 17.6%) and NACT (60-69a: 25.5%; ≥70a 22.8%). Overall pCR rates were higher in younger patients than older patients (≤29a: 30.4% vs. ≥70: 16.7%).

Conclusion Our data from a nationwide cohort reveal a relevant discrepancy concerning the use of chemotherapy in dependence of age.

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Publication History

Article published online:
01 June 2021