Survival outcomes for breast cancer patients who decline recommended treatment: a propensity score-matched analysis

2021 ◽  
Vol 47 (1) ◽  
pp. e5
Author(s):  
Rashmi Shingde ◽  
Shehnarz Salindera ◽  
Noel Aherne ◽  
Lee Millard-Newton ◽  
Adelene Houlton ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Propensity Score ◽  
Cancer Patients ◽  
Survival Outcomes ◽  
Breast Cancer Patients ◽  
Recommended Treatment

Survival outcomes for breast cancer patients who decline recommended treatment: a propensity score‐matched analysis

2021 ◽  
Author(s):  
Rashmi Shingde ◽  
Shehnarz Salindera ◽  
Noel J. Aherne ◽  
Lee Millard‐Newton ◽  
Adelene Houlton ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Propensity Score ◽  
Cancer Patients ◽  
Survival Outcomes ◽  
Breast Cancer Patients ◽  
Recommended Treatment

scholarly journals Clinical and Pathological Characteristics of Young Female Breast Cancer

2021 ◽  
Author(s):  
Dan Zheng ◽  
Ting Luo ◽  
Xiaorong Zhong ◽  
Chengshi Wang ◽  
Ping He ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Propensity Score ◽  
Cancer Patients ◽  
Young Women ◽  
Hormone Receptor ◽  
Adjuvant Radiotherapy ◽  
Survival Outcomes ◽  
Breast Cancer Patients ◽  
Young Breast Cancer

Abstract BackgroundWith the increase in socioeconomic status and development of early screening technologies, the proportion of young breast cancer has gradually increased. However, epidemiological research on breast cancer in young women is lagging. There is a lack of diagnosis and treatment guidelines specifically for young breast cancer patients. MethodsThis is an single-center, retrospective cohort study which adopted 2,142 women ≤ 41 years who were diagnosed with stage I-III invasive breast cancer. Patients were grouped into hormone receptor-positive and -negative groups. Variance of common characteristics between the two groups were compared using Chi-square test, Fisher-exact test and Wilcoxon rank sum test. Cox proportional hazards regression was employed for survival estimation and Kaplan–Meier curves were used to graphically present the survival data. Propensity score matching was used to balanced covariates between patients who received or not received the same treatment. ResultsThe median age of the whole cohort was 37 (16-40), and 75.0% suffered from hormone receptor (HR) positive tumors. Modified radical mastectomy was the most frequent surgery (77.7%), and 78.7% women received adjuvant chemotherapy. Adjuvant radiotherapy was implemented in 39.0% of patients, and 58.3% women did not receive radiotherapy. The HR-positive status independently predicted unfavorable overall survival (OS, HR = 1.50, 95% CI 1.03-2.21, P = 0.04) and invasive disease-free survival (iDFS, HR = 1.47, 95% CI 1.05-2.05, P = 0.02). After propensity score matching (PSM), adjuvant chemotherapy (HR = 0.47, 95% CI 0.26-0.87, P = 0.02), and adjuvant radiotherapy (HR = 0.54, 95% CI 0.37-0.78, P = 0.001) improved OS significantly. Adjuvant chemotherapy predicted favorable iDFS (HR = 0.60, 95% CI 0.38-0.94, P = 0.03). Endocrine therapy improved both OS and iDFS in patients with HR-positive disease. ConclusionThe number of young women with breast cancer is gradually increasing, and these women have worse survival outcomes than their elder counterparts. HR-positive disease predicted worse long-term survival outcomes. Adjuvant chemotherapy and adjuvant radiotherapy were required for all of the young patients. Young women with HR-positive disease can benefit from endocrine therapy. No clear benefit was seen from neoadjuvant chemotherapy in young women with early-stage breast cancer.

Postmastectomy Radiotherapy in T1–2 Female Breast Cancer Patients with 1–3 Positive Axillary Lymph Nodes: A Propensity Score Matched SEER Analysis

2021 ◽  
Author(s):  
Gang Xu ◽  
Shanshan Bu ◽  
Xiushen Wang ◽  
Hong Ge
Keyword(s):  
Breast Cancer ◽  
Propensity Score ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Female Breast Cancer ◽  
Axillary Lymph ◽  
Breast Cancer Patients ◽  
Postmastectomy Radiotherapy ◽  
Female Breast ◽  
Positive Lymph Nodes

Abstract Purpose The application of postmastectomy radiotherapy (PMRT) in T1–2 female breast cancer patients with 1–3 positive lymph nodes has been controversial. We sought to determine the survival benefits of PMRT in the patients with T1–2 and 1–3 positive nodes. Methods A retrospective study using the Surveillance, Epidemiology, and End Results (SEER) Regs Custom Data (with additional treatment fields) from 2001 to 2011 was performed. Patients who received PMRT were matched by the propensity score with patients who did not receive PMRT. The Overall survival (OS) and breast cancer-specific survival (BCSS) were analyzed. Results We identified 56,725 female breast cancer patients with T1–2 and 1–3 positive nodes, and 18,646 patients were included in the analysis. After propensity score matching (1:1), with a median follow-up of 116 months, PMRT showed an increase in the OS (P = 0.018) but had no effect on the BCSS. The 10-year OS rates were 76.8% and 74.4%, and the 10-year BCSS rates were 82.8% and 82.2% for the patients who received and who did not receive PMRT, respectively. Only patients with 3 positive nodes could gain the benefit of PMRT for BCSS. Conclusion PMRT for patients with T1–2 and 1–3 positive lymph nodes could increase the 10-year OS, and had no effect on the 10-year BCSS. Subgroup analysis indicated that only patients with 3 positive lymph nodes could benefit from PMRT for both the OS and BCSS.

Survival Outcomes In Human Epidermal Growth Factor Receptor 2 (HER 2) Positive Breast Cancer Patients At Kenyatta National Hospital

2021 ◽  
Author(s):  
Gloria Tuwei ◽  
Amsalu Degu
Keyword(s):  
Breast Cancer ◽  
Survival Rate ◽  
Cancer Patients ◽  
Survival Outcomes ◽  
Breast Cancer Patients ◽  
Her2 Positive ◽  
Predictors Of Mortality ◽  
Her2 Positive Breast Cancer ◽  
The Mean ◽  
Positive Breast Cancer

Abstract Background: For several years, HER2-positive breast cancer was associated with poor outcomes and higher mortality rates than other breast cancer subtypes. Nevertheless, the advent of Trastuzumab has significantly changed the treatment paradigm of HER2-positive breast cancer. However, it is not an affordable treatment option in sub-Saharan African countries. Besides, there was a lack of comprehensive data about the survival outcomes of HER2-positive breast cancer patients in our setting. Hence, the present study aimed to determine the survival outcomes among HER2-positive breast cancer patients at the Oncology Department of Kenyatta National Hospital.Methods: A hospital-based retrospective cohort design was used to evaluate the survival outcomes, and associated factors among patients with HER2-positive breast cancer admitted between 2015 and 2019 at Kenyatta National Hospital. A total of 50 eligible HER2-positive breast cancer patients were included in the study. In the pre-designed data abstraction tool, the data were collected by reviewing the medical records of the patients. The data were entered and analyzed using the Statistical Package for the Social Sciences version 27 software. The mean survival time was estimated using Kaplan Meier survival analysis. Cox regression analysis was employed to estimate the predictors of mortality among HER2-positive breast cancer patients.Results: The study showed that the overall survival rate was 30%, with a significant decrease in the percentage survival rate across the five years. More than half of the study participants (26, 52%) showed cancer progression during the last follow-up period. The present study showed that the mean cancer-specific survival rate among the study patients was 26.74±18.395 months. The study showed that the mean survival time of patients aged below 60 years (32.513 months), without co-morbidities (34.40 months), and the early stage of the disease (50.639 months) was higher than their counterparts. Multivariate cox-regression analysis revealed that advanced stage (AHR=13.1, 95% CI=2.6-66.6, P=0.002 and distant metastasis (AHR=15.0, 95% CI=3.6-62.8, P≤0.001) were the significant predictors of mortality among HER2 positive breast cancer patients.Conclusions: The overall survival rate of HER 2 positive breast cancer was 30%. Advanced stage and distant metastasis were the significant predictors of mortality among HER2-positive breast cancer patients.

Breast-Conserving Therapy is Associated with Better Survival than Mastectomy in Early-Stage Breast Cancer: A Propensity Score Analysis

2021 ◽  
Author(s):  
Jiali Ji ◽  
Shushu Yuan ◽  
Jiawei He ◽  
Hong Liu ◽  
Lei Yang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Propensity Score ◽  
Cancer Patients ◽  
Propensity Score Analysis ◽  
Early Stage ◽  
Breast Conserving Therapy ◽  
Early Stage Breast Cancer ◽  
Breast Cancer Patients ◽  
Kaplan Meier ◽  
Score Analysis

Abstract Background: Recent retrospective studies have reported that breast-conserving therapy (BCT) led to improved overall survival (OS) than mastectomy in some populations. We aimed to compare the efficacy of BCT and mastectomy using the SEER database. Methods: Between 2010 and 2015, 99,790 eligible patients were identified. We included early-stage breast cancer patients with 5cm or smaller tumors and three or fewer positive lymph nodes in our study. We compared the OS results among patients with BCT and mastectomy. Kaplan-Meier plots, Cox proportional hazard regressions were used to evaluate the outcomes. Propensity-score matching was used to assemble a cohort of patients with similar baseline characteristics. Results: In our study, 77,452 (77.6%) patients underwent BCT and 22,338 (22.4%) underwent mastectomy. The 5-year OS rate was 94.7% in the BCT group and 87.6% in the mastectomy group (P <0.001). After matching, multivariate analysis in the matched cohort showed that women underwent mastectomy was associated with worse OS results compared with those with BCT (Hazard ratio (HR) = 1.628; 95% confidence intervals (CIs) = 1.445- 1.834, P<0.001). Patients with different subtypes and age group (>50 years old; ≤50 years old) received BCT all showed significantly better OS than those received mastectomy. The effect of surgery choice on survival was the same in matched and all cohorts. Conclusions: Our study showed that BCT was associated with improved survival compared with mastectomy in early-stage breast cancer patients. It seems advisable to encourage patients to receive BCT rather than mastectomy in early-stage patients when feasible and appropriate.

Postmastectomy Radiotherapy in T1–2 Women Breast Cancer Patients with 1–3 Positive Axillary Lymph Nodes: A Propensity Score Matched SEER Analysis

2020 ◽  
Author(s):  
Gang Xu ◽  
Shanshan Bu ◽  
Xiushen Wang ◽  
Hong Ge
Keyword(s):  
Breast Cancer ◽  
Propensity Score ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Breast Cancer Patients ◽  
Cancer Specific Survival ◽  
Postmastectomy Radiotherapy ◽  
Positive Lymph Nodes

Abstract Purpose: The application of postmastectomy radiotherapy (PMRT) in T1–2 women breast cancer patients with 1–3 positive lymph nodes has been controversial. We sought to determine the survival benefits of PMRT in the patients with T1–2 and 1–3 positive nodes.Methods: A retrospective study using the Surveillance, Epidemiology, and End Results (SEER) Regs Custom Data (with additional treatment fields) from 2001 to 2011 was performed. Patients who received PMRT were matched by the propensity score with patients who did not receive PMRT. The Overall survival (OS) and breast cancer-specific survival (BCSS) were analyzed. Results: We identified 56,725 women breast cancer patients with T1–2 and 1–3 positive nodes, and 18,646 patients were included in the analysis. After propensity score matching (1:1), with a median follow-up of 116 months, PMRT showed an increase in the OS (P = 0.018) but had no effect on the BCSS. The 10-year OS rates were 76.8% and 74.4%, and the 10-year BCSS rates were 82.8% and 82.2% for the patients who received and who did not receive PMRT, respectively. Only patients with 3 positive nodes could gain the benefit of PMRT for BCSS.Conclusion: PMRT for patients with T1–2 and 1–3 positive lymph nodes could increase the 10-year OS, and had no effect on the 10-year BCSS. Subgroup analysis indicated that only patients with 3 positive lymph nodes could benefit from PMRT for both the OS and BCSS.

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