Frailty Predicts Noninitiation but Not Discontinuation of Adjuvant Hormonal Therapy in Older Women With Breast Cancer

Editor’s note: It can be useful to understand why cancer patients and their doctors make certain treatment decisions. In a new study, scientists investigated how frailty affects decisions about hormonal therapy for older women with breast cancer. The study involved women aged 65 years or older who had invasive non-metastatic breast cancer. The researchers found that frail patients were less likely to start adjuvant hormonal therapy (treatment to keep cancer from returning after it was surgically removed). But frailty did not seem to affect whether or not a woman chose to stop hormone therapy treatment early.


“In a study reported in the Journal of Clinical Oncology, Sheppard et al found that frailty was a significant predictor of not starting adjuvant hormonal therapy in breast cancer patients aged ≥ 65 years, but was not predictive of discontinuation of treatment.

“Study details: The study was performed in a prospective cohort (Cancer and Leukemia Group B [CALGB] 369901) of 1,288 women aged ≥ 65 years diagnosed with invasive nonmetastatic breast cancer recruited from 78 sites between 2004 and 2011. Of these, 1,062 had estrogen receptor–positive tumors.

“Interviews were conducted at baseline, 6 months, and every year up to 7 years. Initiation of hormone therapy was identified from records and discontinuation was identified by self-report. Baseline frailty was measured using a validated 35-item scale, with patients being characterized as prefrail, frail, or robust.”