Chronological age or biological age: What drives the choice of adjuvant treatment in elderly breast cancer patients?

Abstract Background The aim of this study was to analyze biopsychosocial factors affecting how patients cope with cancer and adjuvant treatment and to appraise psychological distress, coping, perceived social support, quality of life and SDM before and after adjuvant treatment in breast cancer patients compared to colon cancer patients. Methods NEOcoping is a national, multicenter, cross-sectional, prospective study. The sample comprised 266 patients with colon cancer and 231 with breast cancer. The instruments used were the Brief Symptom Inventory (BSI), Mini-Mental Adjustment to Cancer (Mini-MAC), Multidimensional Scale of Perceived Social Support (MSPSS), Shared Decision-Making Questionnaire-Patient (SDM-Q-9) and Physician’s (SDM-Q-Doc), and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ). Results Breast cancer patients reacted worse to the diagnosis of cancer with more symptoms of anxiety, depression, and somatization, and were less satisfied with their involvement than those with colon cancer (p = 0.003). Participants with colon cancer were older and had more physical symptoms and functional limitations at the beginning of adjuvant treatment, while there were scarcely any differences between the two groups at the end of adjuvancy, at which time both groups suffered greater psychological and physical effects and scored lower on coping strategies, except for anxious preoccupation. Conclusions Breast cancer patients need more information and involvement of the oncologist in shared decision-making, as well as and more medical and psychological support when beginning adjuvant treatment. Both breast and colon cancer patients may require additional psychological care at the end of adjuvancy.

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Use of second generation breast cancer recurrence test in Indian cohort of early breast cancer patients for adjuvant treatment recommendation: first prospective multicentric Indian study

The Breast ◽

10.1016/s0960-9776(19)30345-5 ◽

2019 ◽

Vol 44 ◽

pp. S99-S100

Author(s):

S. Somashekhar ◽

S.S. Zaveri ◽

R. Kumar ◽

C. Bahl ◽

C. Rohit Kumar ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Early Breast Cancer ◽

Adjuvant Treatment ◽

Second Generation ◽

Cancer Recurrence ◽

Breast Cancer Recurrence ◽

Treatment Recommendation ◽

Breast Cancer Patients ◽

Indian Study

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Cognitive function in breast cancer patients prior to adjuvant treatment

Breast Cancer Research and Treatment ◽

10.1007/s10549-007-9686-5 ◽

2007 ◽

Vol 110 (1) ◽

pp. 143-152 ◽

Cited By ~ 196

Author(s):

Tim A. Ahles ◽

Andrew J. Saykin ◽

Brenna C. McDonald ◽

Charlotte T. Furstenberg ◽

Bernard F. Cole ◽

...

Keyword(s):

Breast Cancer ◽

Cognitive Function ◽

Cancer Patients ◽

Adjuvant Treatment ◽

Breast Cancer Patients

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Persistence of disseminated tumor cells (DTC) in bone marrow (BM) of breast cancer patients predicts increased risk for relapse—Results of pooled European data

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.10083 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 10083-10083 ◽

Cited By ~ 5

Author(s):

W. J. Janni ◽

G. Wiedswang ◽

T. Fehm ◽

J. Jueckstock ◽

E. Borgen ◽

...

Keyword(s):

Breast Cancer ◽

Bone Marrow ◽

Adjuvant Therapy ◽

Cancer Patients ◽

Adjuvant Treatment ◽

Prognostic Significance ◽

Primary Diagnosis ◽

Nodal Status ◽

Breast Cancer Patients ◽

Increased Risk

10083 Background: The prognostic significance of DTC in the BM of breast cancer patients at the time of primary diagnosis has recently been confirmed by a large pooled analysis. If the persistence of DTC after adjuvant therapy confers a similar risk for relapse, there might be an indication for secondary adjuvant treatment. Methods: We analyzed BM aspirates of 697 patients from academic breast cancer units in Oslo (n=356), Munich (n=228) and Tuebingen (n=113) during recurrence-free follow-up at a median interval of 32.4 months (standard deviation [std] 19.4 mon) after primary diagnosis of breast cancer pT1–4, pN0–3 pM0. Carcinoma cells were detected using a standardized immunoassay with the monoclonal antibodies A45-B/B3 (Munich, Tuebingen), or AE1 and AE3 (Oslo), directed against cytokeratin (CK). Patients were followed for a median of 54.2 months (std 24.5 mon) after primary diagnosis. Results: Persistent DTC in the BM were detected in 15.6% of the patients (n=109). The Kaplan-Meier estimate for mean distant relapse-free survival estimate was 155.6 mon (142.4 - 168.9 95%CI) in patients with negative and 102.3 mon (93.6 - 111.0, 95% CI, p< .0001, log rank test) in patients with positive BM status. Patients without evidence of persistent DTC had a significantly longer overall survival (164.4 [155.6 - 173.3]), than patients with positive BM status (101.7 mon [89.4 - 113.9], p< .0001). In multivariate Cox regression analysis, allowing for bone marrow status, tumor size, nodal status, histopathological grading and hormone receptor status, DTC was of higher independent prognostic significance for subsequent reduced breast cancer specific survival (RR 5.9, 2.8 - 12.8, 95% CI, p< .0001), than nodal status at time of primary diagnosis (RR 1.2, 1.0 - 1.3, 95% CI, p=.014). Conclusion: Evidence of persistent DTC in breast cancer patients indicates an increased risk for subsequent relapse, and may serve for monitoring in future clinical trials. Such trials might investigate the benefit of individualized secondary adjuvant treatment or extended adjuvant therapy of patients with DTC. No significant financial relationships to disclose.

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Outcome of adjuvant treatment in elderly Turkish breast cancer patients

Journal of Clinical Oncology ◽

10.1200/jco.2005.23.16_suppl.896 ◽

2005 ◽

Vol 23 (16_suppl) ◽

pp. 896-896

Author(s):

M. Ekenel ◽

G. Basaran ◽

F. Dane ◽

S. Iyikesici ◽

F. Yumuk ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Adjuvant Treatment ◽

Breast Cancer Patients

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Relationship between numeracy and breast cancer patients’ estimates of adjuvant treatment benefit

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.586 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 586-586 ◽

Cited By ~ 1

Author(s):

I. M. Lipkus ◽

G. G. Kimmick ◽

S. Y. Chui ◽

D. L. Fifield ◽

L. A. Werner ◽

...

Keyword(s):

Breast Cancer ◽

Treatment Outcomes ◽

Cancer Patients ◽

Treatment Option ◽

Adjuvant Treatment ◽

Hormonal Therapy ◽

Combined Therapy ◽

Statistical Information ◽

Breast Cancer Patients ◽

Numeracy Skills

586 Background: Based on clinical anecdotes and existing literature, the general population has trouble understanding and making use of statistical information. We explored the accuracy of breast cancer patients’ (pts) estimates of treatment outcomes (probabilities of remaining cancer free versus recurring) relative to data provided by ‘Adjuvant! Online‘ decision aid program, and whether accuracy differed by pts numeracy skills (i.e. use of mathematical concepts and operations). Methods: 43 ER+ women with early stage, node-negative breast cancer were recruited (mean age 56, 72% Caucasian). After signing an informed consent and completing an assessment of numeracy (Lipkus et al., 2001), pts discussed case-specific Adjuvant! print-outs with an oncologist. Pts then estimated their chances of being cancer free after receiving no further treatment, hormonal therapy only, chemotherapy only, or both. Pts also were asked to select the treatment option that afforded their best chance of remaining cancer free. Results: Compared to the estimates provided by Adjuvant! Online, pts underestimated their chance of being cancer free after receiving no further treatment (M=62 vs. 48 out of 100), hormonal therapy only (M=72 vs. 45), chemotherapy only, (M=71 vs.42), and combined therapy (M=78 vs. 54). 63% correctly selected the treatment option that afforded the highest estimate of being cancer free. More numerate patients were more likely to correctly specify which treatment option provided the best chance of being cancer free (OR=0.67, 95% CI: 0.50, 0.89, p<.006); and less likely to give personal estimates of being cancer free inconsistent with estimates provided by Adjuvant! for hormonal therapy (OR=0.17, 95% CI: 0.04, 0.72, p<.02), chemotherapy (OR=0.62, 95% CI: 0.39, 0.99, p<.05) and combined therapy (OR=0.44, 95% CI: 0.23, 0.85, p<.02). Conclusions: Findings suggest that pt numeracy skills are important in comprehending statistical data about adjuvant treatment outcomes. Numeracy skills may have implications for how statistical information about treatment is presented and discussed, affecting processes of informed decision-making and pt quality of life. No significant financial relationships to disclose.

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Randomized phase II trial evaluating the efficacy of adding sequential half body irradiation (SHBI) to adjuvant chemotherapy in high-risk breast cancer patients with >10 positive lymph nodes

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.627 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 627-627

Author(s):

M. S. Barsoum ◽

R. M. Gafar ◽

M. M. Nazmy ◽

A. Niazy

Keyword(s):

Breast Cancer ◽

Lymph Nodes ◽

Cancer Patients ◽

Phase Ii ◽

Adjuvant Treatment ◽

Phase Ii Trial ◽

Phase Iii ◽

Breast Cancer Patients ◽

Er Positive ◽

Positive Lymph Nodes

627 Background: Adjuvant sequential half body irradiation (SHBI) is both interesting as well as scientifically sound approach with proven efficacy in many tumors. Methods: Patients with node positive (≥10) breast cancer were randomized in this phase II trial to receive either 6 cycles of adjuvant cyclophosphamide 500 mg/m2, 5FU 500 mg/m2 and epirubicin 100 mg/m2 followed by postoperative local irradiation (Arm A) versus the same adjuvant treatment plus consolidation SHBI staring 3 weeks after end of adjuvant treatment with upper half 750cGy /5 fractions /1week then one month gap followed by the lower half for the same dose (Arm B) Results: Between November 1999 and November 2000 a total of 70 patients who met the eligibility criteria were enrolled. Arm A (n=35) and arm B (n=35) were almost comparable with the respect to different prognostic factors. There was significant improvement in the disease free survival (DFS) at 5 years in arm B. The DFS was 65±8% in arm B while it was 33±8% in arm A (log-rank test: P =0.0036). In subset analysis the difference is apparent in subgroups of patients with less potential metastatic burden, which are T2 cases and ER positive cases. The DFS at 5 years was 83% in arm B and it was 35% in arm A (P=0.0008) in T2 cases. In the subgroup of patients with ER positive tumors (n=51), the DFS at 4 years was 58% in arm B and it was 25% in arm A (P=0.0072). The complications of the addition of SHBI were mild (grades 2 and 3) and mainly gastrointestinal (vomiting, diarrhea and colic). In both arms of the study there were no life-threatening complications or treatment-related mortality. Conclusions: SHBI was found to be a well-tolerated consolidation regimen with acceptable side effects and it showed significant improvement of the DFS in breast cancer patients with ≥ 10 positive lymph nodes especially in the relative cases with good prognosis (T2-ER positive). This makes it worthy of testing in a phase III trial. No significant financial relationships to disclose.

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