Frequency of axillary node dissection and chemotherapy in breast cancer patients over 60 years of age compared with those younger than 60 years of age
Bibliographic record
Abstract
8161 Background: Axillary lymph node dissection (ALND) is used to stage breast cancer (BRCA) patients and to select appropriate adjuvant therapy. Older patients may not be offered ALND under the assumption they would not be candidates for chemotherapy. As a result, many patients over age 60 may be undertreated and have an increased risk of BRCA recurrence. The purpose of this study is to compare the rate of chemotherapy and ALND in patients older than 60 years with patients younger than 60 years. Methods: Retrospective chart review of invasive BRCA patients referred for adjuvant treatment at a single academic centre between January 1999 and March 2001. Demographic information, tumour characteristics, surgical and chemotherapy treatment data were collected. Co-morbidity was documented using the Charlson score which assigns 1–2 points for conditions including diabetes, angina, and vascular disease. Results: 293 patients less than 79 years of age were identified. In 166 patients under 60 years, 93.4% received node dissections, 69.3% received chemotherapy and 3.6% declined chemotherapy. However, of 127 patients between 60 and 79 years, 61.5% received axillary dissections, 29.1% received chemotherapy, and 9.5% declined chemotherapy. Average co-morbidity scores for patients less than 60 were 0.14, while those above 60 were slightly higher at 0.54. 7.2% of patients below age 60 had co-morbidities, in comparison 31.5% of those 60–79 had co-morbidities. Of those over 60 years with co-morbidity, the majority had only 1–2 health problems (80%). Tumour size (21 mm vs. 18 mm) and number of lymph nodes in those with ALND (1.1 vs. 0.8) were similar between groups. Conclusions: Although women aged 60–79 did not have a heavy burden of co-morbid illness; they were less likely to receive ALND or chemotherapy. Treatment decisions may be influenced by age rather than by co-morbid status or patient preference in those aged 60–79 who may otherwise be candidates for more aggressive treatment. No significant financial relationships to disclose.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".