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9 april 2026: Bron: JAMA Published Online: April 6, 2026

Chemotherapie na geslaagde operatie geeft bij oudere vrouwen in de leeftijd van 70+ met triple negatieve borstkanker een behoorlijk betere overleving van 16 procent voor stadium I, 20 procent voor stadium II tot 24 procent voor stadium III in vergelijking met vrouwen die na een operatie geen chemotherapie hadden gehad.

Dat blijkt uit een retrospectieve studie onder totaal 5730 borstkankerpatiënten met triple negatieve borstkanker. Verdeling van de vrouwelijke deelnemers (er deden geen mannen met borstkanker mee aan deze studie) was: 2509 patiënten kregen chemotherapie en 3221 patiënten kregen geen chemotherapie.

Patiënten die chemotherapie kregen waren jonger (mediane leeftijd, 74 [IQR, 71-77] versus 79 [IQR, 74-84] jaar) en hadden een meer gevorderd stadium van de ziekte (stadium II-III, 1388 [54,5%] versus 1664 [51,7%]) dan patiënten die geen chemotherapie kregen.

Chemotherapie na geslaagde operatieve ingreep was geassocieerd met een verbeterde borstkankerspecifieke overleving en algehele overleving. Vergelijkbare resultaten werden waargenomen in de verschillende subgroepen. 

Hier een schema van de deelnemers:Baseline Characteristics of Older Patients With Stages I to III Triple-Negative Breast Cancer

De mediane follow-up van de studie bedroeg 46 maanden (IQR, 21-83). Statistische analyses werden uitgevoerd op 4 augustus 2025. Tijdens de mediane follow-up van 46 maanden overleden 1980 patiënten (34,6%) met triple negatieve borstkanker (TNBC) in stadium I tot III.

  • De 5-jaarsoverleving was hoger voor patiënten die chemotherapie kregen dan voor patiënten die dat niet kregen (76,4% versus 60,9%).
  • De 5-jaarsoverleving voor patiënten met en zonder chemotherapie was respectievelijk 87,9% versus 77,3% bij patiënten met stadium I,
  • 73,2% versus 54,0% bij patiënten met stadium II en
  • 45,3% versus 21,9% bij patiënten met stadium III.

De onderzoekers concluderen dan ook: In deze cohortstudie onder oudere vrouwen met triple negatieve borstkanker (TNBC) werd aanvullende chemotherapie na geslaagde operatieve ingreep geassocieerd met verbeterde overlevingsresultaten. Onderbenutting van adjuvante chemotherapie bij oudere vrouwen kan bijdragen aan slechtere uitkomsten. Geriatrische beoordelingsinstrumenten kunnen helpen bij het nemen van individuele behandelbeslissingen en het bevorderen van gelijke zorg.

Het volledige studierapport is gratis in te zien of te downloaden. Klik daarvoor op de titel van het abstract:

Adjuvant Chemotherapy Outcomes in Older Adults With Nonmetastatic Triple-Negative Breast Cancer




Key Points

Question  Among older women with nonmetastatic triple-negative breast cancer, is adjuvant chemotherapy associated with better survival outcomes compared with no chemotherapy?

Findings  In this cohort study of 5730 patients 70 years or older with nonmetastatic triple-negative breast cancer, receipt of adjuvant chemotherapy was associated with improved breast cancer–specific survival and overall survival compared with no chemotherapy.

Meaning  These findings suggest that even among older patients—who may be more vulnerable to toxic effects of treatment—chemotherapy can meaningfully extend life and reduce the risk of death from breast cancer.

Abstract

Importance  Triple-negative breast cancer (TNBC) is an aggressive subtype of breast cancer for which current guidelines recommend adjuvant chemotherapy. Data about the benefit of adjuvant chemotherapy in older women with TNBC are scarce.

Objective  To assess the survival benefit of adjuvant chemotherapy in older women with nonmetastatic TNBC.

Design, Setting, and Participants  This retrospective population-based cohort study used the Surveillance, Epidemiology, and End Results database from January 1, 2010, to December 31, 2021. Participants included women 70 years or older with nonmetastatic TNBC who underwent surgical removal of breast tumor and were candidates for adjuvant chemotherapy. The median follow-up was 46 (IQR, 21-83) months. Statistical analysis was conducted on August 4, 2025.

Exposure  Receipt or nonreceipt of adjuvant chemotherapy.

Main Outcomes and Measures  The primary outcome was breast cancer–specific survival between patients who received chemotherapy and those who did not. Logistic regression models assessed variables associated with chemotherapy use. Machine learning with a generalized boosted model was used to estimate propensity scores. Inverse probability of treatment weighting and Cox proportional hazards regression methods were used to compare breast cancer–specific and overall survival.

Results  A total of 5730 women (median age, 76 [IQR, 73-81] years) were included in the analysis; 2509 received chemotherapy and 3221 did not. Patients who received chemotherapy were younger (median age, 74 [IQR, 71-77] vs 79 [IQR, 74-84] years) and had more advanced disease (stage II-III, 1388 [54%.5] vs 1664 [51.7%]) than those who did not. Adjuvant chemotherapy was associated with improved breast cancer–specific survival (hazard ratio , 0.69; 95% CI, 0.58-0.82) and overall survival (HR, 0.55; 95% CI, 0.49-0.62). Similar results were observed across subgroups. Increasing age (odds ratio for 80-89 years, 0.15 [95% CI, 0.13-0.17]; OR for ≥90 years, 0.02 [95% CI, 0.01-0.04]) was associated with lower odds of receiving adjuvant chemotherapy.

Conclusions and Relevance  In this cohort study of older women with TNBC, adjuvant chemotherapy was associated with improved survival outcomes. Underutilization of adjuvant chemotherapy in older women may contribute to worse outcomes. Geriatric assessment tools may help guide individualized treatment decisions and promote equitable care.

Article Information

Accepted for Publication: February 10, 2026.

Published: April 6, 2026. doi:10.1001/jamanetworkopen.2026.5061

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2026 Anampa JD et al. JAMA Network Open.

Corresponding Author: Jesus D. Anampa, MD, MS, Montefiore Einstein Comprehensive Cancer Center, 1695 Eastchester Rd, 2nd Floor, Bronx, NY 10461 (janampa@montefiore.org).

Author Contributions: Dr Anampa had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Anampa, Obeng-Gyasi, Alvarez Soto, Bernabe Ramirez, Xue.

Acquisition, analysis, or interpretation of data: Anampa, Avila, Brodsky, Hakim, Alvarez Soto, Xue.

Drafting of the manuscript: Anampa, Avila, Brodsky.

Critical review of the manuscript for important intellectual content: Anampa, Hakim, Obeng-Gyasi, Alvarez Soto, Bernabe Ramirez, Xue.

Statistical analysis: Anampa, Xue.

Obtained funding: Anampa.

Administrative, technical, or material support: Anampa, Hakim, Alvarez Soto, Bernabe Ramirez.

Supervision: Anampa, Obeng-Gyasi.

Conflict of Interest Disclosures: None reported.

Funding/Support: Dr Anampa was supported by grant 5K12CA132783-08 from the Einstein Paul Calabresi Career Development Program of the National Institutes of Health and CTSA award number UL1 TR002556 from the National Center for Advancing Translational Sciences, National Institutes of Health.

Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Data Sharing Statement: See Supplement 2.

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