Regional variation in breast cancer treatment throughout the United States

195 Background: In the United States, 203,000 women are diagnosed annually with breast cancer (BC). Currently, over 2.3 million women in the United States are breast cancer survivors. With the increased incidence and survivorship, more women are living with the long-term treatment effects such as lymphedema (LE). We are nearing completion of stage one of a three-stage research project to examine genetic factors that potentially predispose BC survivors to develop LE. In stage one, we are working to identify novel genetic polymorphisms pointing to genomic regions and genes associated with LE risk. In stage two, we will use exome sequencing to examine both rare and common genetic variants potentially associated with variation in symptom manifestations of LE in breast cancer survivors; to examine phenotypic and genotypic variation in LE emerging following cancer treatment; and to examine associations between LE phenotypes among breast cancer survivors with LE and genomic factors and non-genomic factors. In stage three, we will replicate at the genetic level the associations detected. Methods: Institutional funding was obtained for a GWAS-design feasibility study with 96 breast cancer survivors with and without LE (48/48). Genetic material (from buccal swabs), limb volume (by perometry and circumferences), and self-reported LE-related symptoms were collected in one laboratory appointment. Results: Ninety-five percent of survivors participating in an on-going longitudinal study consented to participate in the genetic pilot (N=96). Buccal swabs provided yield for DNA extraction (concentration average 174.94 ng/ul). An additional 96 specimens have been collected for a second pilot GWAS (N =192). Conclusions: The pilot findings form the basis for a larger multisite proposed study to examine genetic predisposition to secondary LE. The findings of the larger study will lead to the design and timing of subsequent interventions aimed at reducing LE risk and improving overall survivorship quality of life. Findings concerning interactions among best cancer treatments and LE genetic predisposition will have the potential to guide the selection of cancer treatment to minimize complications when survival outcomes are equivalent across competing treatment approaches.

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Is mode of breast cancer detection associated with cancer treatment in the United States?

Cancer ◽

10.1002/cncr.23260 ◽

2008 ◽

Vol 112 (5) ◽

pp. 1011-1019 ◽

Cited By ~ 5

Author(s):

K. Robin Yabroff ◽

Linda C. Harlan ◽

Limin X. Clegg ◽

Rachel Ballard-Barbash ◽

Jennifer Stevens ◽

...

Keyword(s):

Breast Cancer ◽

United States ◽

Cancer Treatment ◽

Cancer Detection ◽

The United States ◽

Breast Cancer Detection

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Regional variation in breast cancer treatment in the Netherlands and the role of external peer review: a cohort study comprising 63,516 women

BMC Cancer ◽

10.1186/1471-2407-14-596 ◽

2014 ◽

Vol 14 (1) ◽

Cited By ~ 4

Author(s):

Melvin J Kilsdonk ◽

Boukje AC van Dijk ◽

Renee Otter ◽

Wim H van Harten ◽

Sabine Siesling

Keyword(s):

Breast Cancer ◽

Cohort Study ◽

The Netherlands ◽

Cancer Treatment ◽

Peer Review ◽

Regional Variation ◽

Breast Cancer Treatment

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Breast Cancer

10.2310/surg.2035 ◽

2019 ◽

Author(s):

Stephen B Edge ◽

Lindi VanderWalde ◽

Alyssa D. Throckmorton

Keyword(s):

Breast Cancer ◽

Cancer Treatment ◽

Carcinoma In Situ ◽

Ductal Carcinoma ◽

Lobular Carcinoma ◽

The United States ◽

Breast Cancer Treatment ◽

Western World ◽

Cancer Management

Breast cancer is the most common malignancy in women in the Western world. Its prevalence and public health impact are increasing in developing countries, and breast cancer leads to the death of hundreds of thousands of women worldwide annually. In the United States, surgeons are involved in the treatment of most women with breast cancer and surgical care must be coordinated with other components of comprehensive breast cancer treatment. This review covers breast evaluation and management of findings suspicious for cancer, management of clinical or screening-detected findings, management of breast cancer, noninvasive cancer (carcinoma in situ), invasive breast cancer, special circumstances, and follow-up after breast cancer treatment. This review contains 9 figures, 41 tables, and 106 references. Key words: Breast cancer, ductal carcinoma in situ, lobular carcinoma in situ, chemotherapy, hormone receptor-positive, HER2/neu, breast-conserving therapy, reconstruction, mastectomy, adjuvant therapy, radiation therapy

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