The risk of breast cancer and related comorbidities are positively associated with age. Though chemotherapy is a commonly assigned therapy, not much evidence on the effect of adjuvant therapy in patients with node-positive breast cancer is available. This study aims to investigate the association of chemotherapy with survival in elderly patients with estrogen receptor-positive, node-positive breast cancer, and multiple comorbidities.

This retrospective cohort study included a total of 1,592 patients who were 70 years or older, had estrogen receptor-positive breast cancer and had a Charlson/Deyo comorbidity score of 2 or 3. The patients who underwent surgery for pathologic node-positive breast cancer were included. The primary outcomes of the study were propensity scores based on comorbidity score and age.

Of 1,592 included patients, 350 (22.0%) received chemotherapy and 1,242 (78.0%) did not. In addition, most of the patients who received chemotherapy also received other adjuvant treatments. During a median follow-up of 43.1 months, no statistically substantial difference was observed between patients who underwent chemotherapy and those who did not. Further adjustments suggested that the receipt of chemotherapy was associated with a better rate of survival (HR 0.67).

The research concluded that patients with estrogen receptor-positive, node-positive breast cancer who underwent chemotherapy had a better chance of survival, compared to patients who did not undergo chemotherapy.