Prevalence and determinants of end-of-life chemotherapy use in patients with metastatic breast cancer

Aju Mathew, Tala Achkar, Shira Abberbock, Gurprataap S. Sandhu, Mini Elizabeth Jacob, Vipin Das Villgran, Margaret Q. Rosenzweig, Shannon Puhalla, Adam M. Brufsky

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Cessation of chemotherapy in the last few weeks of life could be an important quality-of-care benchmark. Proportion of metastatic breast cancer patients who receive end-of-life chemotherapy is not well described. We aimed to determine the prevalence and determinants of end-of-life chemotherapy use in patients with metastatic breast cancer. A retrospective cohort study using a prospectively collated database of patients with metastatic breast cancer who died between January 1, 2010, and September 30, 2014, was conducted. End-of-life chemotherapy (EOLC) use was defined as receipt of chemotherapy within 2 weeks of death (EOLC2) and receipt of chemotherapy within 4 weeks of death (EOLC4). Patients who did not receive any chemotherapy in the last 4 weeks before death were categorized as non-EOLC. We identified 274 patients with metastatic breast cancer, of whom 28 received EOLC2 (10.2%) and 62 received EOLC4 (22.6%). In comparison with non-EOLC, patients receiving EOLC4 were younger and had greater disease burden. Patients in EOLC4 group received more number of lines of chemotherapy. In a multivariable analysis, younger age at metastatic disease and greater number of metastatic organ systems involved were predictors of end-of-life chemotherapy use. Prevalence of the use of end-of-life chemotherapy in our cohort was higher than previously described. More end-of-life chemotherapy was used in younger women, and those with greater disease burden. Earlier initiation of end-of-life discussions may be targeted to such patients.

Original languageEnglish (US)
Pages (from-to)718-722
Number of pages5
JournalBreast Journal
Volume23
Issue number6
DOIs
StatePublished - Nov 1 2017
Externally publishedYes

Keywords

  • breast cancer
  • chemotherapy
  • end of life
  • prevalence

ASJC Scopus subject areas

  • Internal Medicine
  • Surgery
  • Oncology

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