The study was done to examine the association of chemotherapy with survival in elderly patients with multiple comorbidities and estrogen receptors–positive, node-positive breast cancer.

This study included patients 70 years or older in age. Propensity scores were used to match patients receiving adjuvant chemotherapy with those not receiving adjuvant chemotherapy based on age, comorbidity score, facility type, facility location, pathologic T and N stage, and receipt of adjuvant endocrine and radiation therapy. Data analysis was then done.

1592 patients were included in the initial non matched analysis. 350 of these patients received chemotherapy, while others did not. Compared with patients who did not receive chemotherapy, patients who received chemotherapy were younger, had larger primary tumors, and had higher pathologic nodal burden with stage pN1 disease. More patients who received chemotherapy also received other adjuvant treatments, including endocrine therapy and radiation therapy. In the matched cohort, with a median follow-up of 43.1 months, no statistically significant difference was found in median overall survival between the chemotherapy and no chemotherapy groups vs 62.7 months. After adjustment for potential confounding factors, receipt of chemotherapy was associated with improved survival.

This study concluded that in node-positive, estrogen receptor–positive elderly patients with breast cancer and multiple comorbidities, receipt of chemotherapy was associated with improved overall survival.