scholarly journals 548Cancer treatment and survival disparity in South Australia women with invasive breast cancer during 2000-2014

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Ming Li ◽  
David Roder
Keyword(s):  
Breast Cancer ◽  
Cancer Registry ◽  
Invasive Breast Cancer ◽  
Systemic Treatment ◽  
Breast Cancer Mortality ◽  
South Australia ◽  
Cancer Death ◽  
Breast Cancer Patients ◽  
Breast Cancer Death ◽  
Treatment Type

Abstract Background Survival improvement from breast cancer has been attributed mostly to treatment advances and earlier cancer detection. This study was to investigate cancer treatment and the association with survival. Methods A total of 13494 female patients with invasive breast cancer recorded on the South Australia Cancer Registry in 2000-2014 were included. Cancer treatments within 12 month following diagnosis were identified from linked cancer registry and other medical registries. Study factors included demo sociographic, tumour profile and comorbidity. Adjusted odds ratios and sub hazard ratios were reported on treatment and survival disparity respectively. Results 98% patients were treated with one or more treatment types. 56% had conserving surgery. Systemic treatment was received by 72%. Older patients with advanced cancer were less likely to have any treatment. Women in the most socioeconomically advantaged area were less likely to have combined mastectomy and conservative surgery (aOR 0.73, 95% CI 0.54-0.98), but more likely to have systemic treatment (aOR 1.44, 95% CI 1.26-1.64). Other factors such as country of birth, residential socioeconomic status, cancer differentiation, and diagnosis period differed in their associations with treatment type. Having conserving surgery predicted the lowest breast cancer death (adjusted SHR 0.31, 95% CI 0.26-0.36) compared to no surgery. Conclusions Breast cancer patients underwent varied treatment types with different impact on breast cancer mortality. Key messages Patients undergoing conserving surgery were at the lowest risk of the cancer death.

Is Breast Cancer Ever Cured? Follow-Up Study of 5623 Breast Cancer Patients

1991 ◽  
Vol 77 (6) ◽  
pp. 465-467 ◽  
Author(s):  
Stefano Ciatto ◽  
Rita Bonardi
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Systemic Disease ◽  
Cancer Death ◽  
Breast Cancer Patients ◽  
Death Rates ◽  
Breast Cancer Death ◽  
Long Term Follow Up

The authors evaluated 5623 cases of primary breast cancer followed for 1 to 21 years. Overall and breast cancer death rates were determined and compared to expected rates. Breast cancer patients showed overall and breast cancer death rates significantly higher than expected and which persisted at long-term follow-up. The observed/expected overall death ratios for follow-up periods of 0–5, 6–10, 11–15 or 16–20 years were 3.61, 2.55, 1.60 and 2.11, respectively. Death rates from breast cancer at 5, 10, 15 and 20 years were 20%, 32%, 40% and 48% respectively. The evidence of a persistent excess mortality even after long-term follow-up suggests the hypothesis that breast cancer is a systemic disease when clinically diagnosed. This study provided no evidence of a « clinical » cure for breast cancer patients. Even for N- patients the 5, 10, 15 and 20 year death rates from breast cancer were 12%, 20%, 28% and 38%, respectively. N- breast cancer, which is currently considered as a localized disease cured by surgery in most cases, would be better regarded to as a slow-growing metastatic disease, although « personal » cure may be achieved in many subjects dying of causes other than breast cancer.

scholarly journals Relationship of Predicted Risk of Developing Invasive Breast Cancer, as Assessed with Three Models, and Breast Cancer Mortality among Breast Cancer Patients

PLoS ONE ◽  
2016 ◽  
Vol 11 (8) ◽  
pp. e0160966 ◽  
Author(s):  
Mark E. Sherman ◽  
Laura Ichikawa ◽  
Ruth M. Pfeiffer ◽  
Diana L. Miglioretti ◽  
Karla Kerlikowske ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Invasive Breast Cancer ◽  
Cancer Mortality ◽  
Breast Cancer Mortality ◽  
Breast Cancer Patients ◽  
Relationship Of ◽  
Predicted Risk

scholarly journals In modern times, how important are breast cancer stage, grade and receptor subtype for survival: a population-based cohort study

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Anna L. V. Johansson ◽  
Cassia B. Trewin ◽  
Irma Fredriksson ◽  
Kristin V. Reinertsen ◽  
Hege Russnes ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Tumour Size ◽  
Breast Cancer Mortality ◽  
Population Based ◽  
Breast Cancer Treatment ◽  
Nodal Status ◽  
Cancer Death ◽  
Node Negative ◽  
Breast Cancer Death ◽  
Grade Tumour

Abstract Background In breast cancer, immunohistochemistry (IHC) subtypes, together with grade and stage, are well-known independent predictors of breast cancer death. Given the immense changes in breast cancer treatment and survival over time, we used recent population-based data to test the combined influence of IHC subtypes, grade and stage on breast cancer death. Methods We identified 24,137 women with invasive breast cancer aged 20 to 74 between 2005 and 2015 in the database of the Cancer Registry of Norway. Kaplan-Meier curves, mortality rates and adjusted hazard ratios for breast cancer death were estimated by IHC subtypes, grade, tumour size and nodal status during 13 years of follow-up. Results Within all IHC subtypes, grade, tumour size and nodal status were independent predictors of breast cancer death. When combining all prognostic factors, the risk of death was 20- to 40-fold higher in the worst groups compared to the group with the smallest size, low grade and ER+PR+HER2− status. Among node-negative ER+HER2− tumours, larger size conferred a significantly increased breast cancer mortality. ER+PR−HER2− tumours of high grade and advanced stage showed particularly high breast cancer mortality similar to TNBC. When examining early versus late mortality, grade, size and nodal status explained most of the late (> 5 years) mortality among ER+ subtypes. Conclusions There is a wide range of risks of dying from breast cancer, also across small breast tumours of low/intermediate grade, and among node-negative tumours. Thus, even with modern breast cancer treatment, stage, grade and molecular subtype (reflected by IHC subtypes) matter for prognosis.

scholarly journals Association of Occupation and Breast Cancer Mortality in the State of Vermont, 1989-1993

2020 ◽  
Vol 5 (2) ◽  
Author(s):  
Dominic F Geffken ◽  
Melissa J Perry ◽  
Peter Callas
Keyword(s):  
Breast Cancer ◽  
Relative Risk ◽  
Cancer Mortality ◽  
Death Rate ◽  
Breast Cancer Mortality ◽  
Occupational Group ◽  
Control Analysis ◽  
Cancer Death ◽  
Breast Cancer Death ◽  
Increased Risk

Vermont’s breast cancer death rate is among the highest in the U.S. This study analyzed the association between breast cancer mortality and occupation in Vermont women. Given that Vermont is a rural state, one initial hypothesis was that occupational exposure to pesticides might partly explain the high death rate. Death certificate data from 1989-1993 were analyzed to determine relative risk of breast cancer death according to occupation. Case-control analysis demonstrated increased relative risk of breast cancer death for women in two broad occupational groups: 1) Executive, Administrator and Managers and 2) Professionals. Decreased relative risk of breast cancer death was seen for the occupational group of Homemaker. Data indicated that women in the occupational group of Farming, Forestry, and Fishing were not at increased risk of dying from breast cancer. The associations of occupation and breast cancer mortality in Vermont women do not differ significantly from those seen in larger U.S. studies.

scholarly journals Imaging Biomarkers as Predictors for Breast Cancer Death

2019 ◽  
Vol 2019 ◽  
pp. 1-12 ◽  
Author(s):  
Wendy Yi-Ying Wu ◽  
Laszlo Tabar ◽  
Tibor Tot ◽  
Ching-Yuan Fann ◽  
Amy Ming-Fang Yen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Treatment Modalities ◽  
Imaging Biomarkers ◽  
Molecular Testing ◽  
Architectural Distortion ◽  
Cancer Death ◽  
Breast Cancer Patients ◽  
Breast Cancer Death ◽  
Basal Phenotype

Background. To differentiate the risk of breast cancer death in a longitudinal cohort using imaging biomarkers of tumor extent and biology, specifically, the mammographic appearance, basal phenotype, histologic tumor distribution, and conventional tumor attributes.Methods. Using a prospective cohort study design, 498 invasive breast cancer patients diagnosed between 1996 and 1998 were used as the test cohort to assess the independent effects of the imaging biomarkers and other predictors on the risk of breast cancer death. External validation was performed with a cohort of 848 patients diagnosed between 2006 and 2010.Results. Mammographic tumor appearance was an independent predictor of risk of breast cancer death (P=0.0003) when conventional tumor attributes and treatment modalities were controlled. The casting type calcifications and architectural distortion were associated with 3.13-fold and 3.19-fold risks of breast cancer death, respectively. The basal phenotype independently conferred a 2.68-fold risk compared with nonbasal phenotype. The observed deaths did not differ significantly from expected deaths in the validation cohort. The application of imaging biomarkers together with other predictors classified twelve categories of risk for breast cancer death.Conclusion. Combining imaging biomarkers such as the mammographic appearance of the tumor with the histopathologic distribution and basal phenotype, accurately predicted long-term risk of breast cancer death. The information may be relevant for determining the need for molecular testing, planning treatment, and determining the most appropriate clinical surveillance schedule for breast cancer patients.

scholarly journals Balancing the benefits and detriments among women targeted by the Norwegian Breast Cancer Screening Program

2016 ◽  
Vol 23 (4) ◽  
pp. 203-209 ◽  
Author(s):  
Solveig Hofvind ◽  
Marta Román ◽  
Sofie Sebuødegård ◽  
Ragnhild S Falk
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Cancer Mortality ◽  
Screening Program ◽  
Breast Cancer Mortality ◽  
Cancer Death ◽  
Breast Cancer Death ◽  
Breast Cancer Screening Program ◽  
Cancer Screening Program

Objective To compute a ratio between the estimated numbers of lives saved from breast cancer death and the number of women diagnosed with a breast cancer that never would have been diagnosed during the woman’s lifetime had she not attended screening (epidemiologic over-diagnosis) in the Norwegian Breast Cancer Screening Program. Methods The Norwegian Breast Cancer Screening Program invites women aged 50–69 to biennial mammographic screening. Results from published studies using individual level data from the programme for estimating breast cancer mortality and epidemiologic over-diagnosis comprised the basis for the ratio. The mortality reduction varied from 36.8% to 43% among screened women, while estimates on epidemiologic over-diagnosis ranged from 7% to 19.6%. We computed the average estimates for both values. The benefit–detriment ratio, number of lives saved, and number of women over-diagnosed were computed for different scenarios of reduction in breast cancer mortality and epidemiologic over-diagnosis. Results For every 10,000 biennially screened women, followed until age 79, we estimated that 53–61 (average 57) women were saved from breast cancer death, and 45–126 (average 82) were over-diagnosed. The benefit–detriment ratio using average estimates was 1:1.4, indicating that the programme saved about one life per 1–2 women with epidemiologic over-diagnosis. Conclusion The benefit–detriment ratio estimates of the Norwegian Breast Cancer Screening Program, expressed as lives saved from breast cancer death and epidemiologic over-diagnosis, should be interpreted with care due to substantial uncertainties in the estimates, and the differences in the scale of values of the events compared.

scholarly journals Long-term prognosis of young breast cancer patients (≤40 years) who did not receive adjuvant systemic treatment: protocol for the PARADIGM initiative cohort study

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e017842 ◽  
Author(s):  
Gwen MHE Dackus ◽  
Natalie D ter Hoeve ◽  
Mark Opdam ◽  
Willem Vreuls ◽  
Zsuzsanna Varga ◽  
...  
Keyword(s):  
Breast Cancer ◽  
The Netherlands ◽  
Cancer Patients ◽  
Cancer Registry ◽  
Systemic Treatment ◽  
Young Patients ◽  
Breast Cancer Patients ◽  
Adjuvant Systemic Treatment ◽  
Netherlands Cancer Registry ◽  
Young Breast Cancer

IntroductionCurrently used tools for breast cancer prognostication and prediction may not adequately reflect a young patient’s prognosis or likely treatment benefit because they were not adequately validated in young patients. Since breast cancers diagnosed at a young age are considered prognostically unfavourable, many treatment guidelines recommend adjuvant systemic treatment for all young patients. Patients cured by locoregional treatment alone are, therefore, overtreated. Lack of prognosticators for young breast cancer patients represents an unmet medical need and has led to the initiation of the PAtients with bReAst cancer DIaGnosed preMenopausally (PARADIGM) initiative. Our aim is to reduce overtreatment of women diagnosed with breast cancer aged≤40 years.Methods and analysisAll young, adjuvant systemic treatment naive breast cancer patients, who had no prior malignancy and were diagnosed between 1989 and 2000, were identified using the population based Netherlands Cancer Registry (n=3525). Archival tumour tissues were retrieved through linkage with the Dutch nationwide pathology registry. Tissue slides will be digitalised and placed on an online image database platform for clinicopathological revision by an international team of breast pathologists. Immunohistochemical subtype will be assessed using tissue microarrays. Tumour RNA will be isolated and subjected to next-generation sequencing. Differences in gene expression found between patients with a favourable and those with a less favourable prognosis will be used to establish a prognostic classifier, using the triple negative patients as proof of principle.Ethics and disseminationObservational data from the Netherlands Cancer Registry and left over archival patient material are used. Therefore, the Dutch law on Research Involving Human Subjects Act (WMO) is not applicable. The PARADIGM study received a ‘non-WMO’ declaration from the Medical Ethics Committee of the Netherlands Cancer Institute - Antoni van Leeuwenhoek hospital, waiving individual patient consent. All data and material used are stored in a coded way. Study results will be presented at international (breast cancer) conferences and published in peer-reviewed, open-access journals.

scholarly journals Medicare Coverage Improves Mortality Outcomes in Regions of Poverty in United States

2021 ◽  
Vol 2 (9) ◽  
pp. 779-783
Author(s):  
Yana Puckett
Keyword(s):  
Breast Cancer ◽  
Cancer Mortality ◽  
Ductal Carcinoma ◽  
Breast Cancer Mortality ◽  
Age Groups ◽  
Care Facility ◽  
Mortality Rates ◽  
Cancer Death ◽  
Residential Care Facility ◽  
Breast Cancer Death

Objectives: Access to care and poverty have been associated with a higher risk of breast cancer, but their impact on breast cancer death has not been fully evaluated. We hypothesized that analysis of data from a large database would further elucidate the association between socioeconomic status and breast cancer mortality. Methods: The Surveillance, Epidemiology, and End Results (SEER) database was used to identify cases of invasive ductal carcinoma diagnosed between 2006-2011, as well as data reflecting the presence or absence of a breast cancer death within five years. Two age groups, 40-64 year old women, and 65+ year old women, were analyzed. From the American Community Survey were acquired annual county level hospital rates, ambulatory care facility rates, nursing/residential care facility rates, rural business rates, population densities, and counts of women in the age groups of interest. Results: With respect to poverty rates, incidence based mortality rates for 40-64 year old women were 13% (99% CI 3%, 25%) higher for counties in the third quartile and 19% (7%, 35%) higher for counties in the fourth quartile (p < 0.01) than for counties in the first quartile; counties in the second quartile did not show higher incidence mortality rates (p > 0.01). Mortality rates for 65+ year old women did not differ among poverty rate quartiles (p > 0.01 for each assessment). A 50% increase in hospitals per 100,000 persons was associated with 8% (5%, 11%) and 5% (1%, 8%) increases in mortality rates for 40-64 y and 65+ y women, respectively, likely reflecting better ascertainment of causes of death at hospitals. Impacts of differences in other rates and population density were not detected (p > 0.01 for each analysis). Conclusion: Counties with higher poverty rates have increased breast cancer mortality rates for 40-64 y women, but not for 65+ y women. Universal coverage associated with Medicare is associated with the absence of an apparent effect of poverty upon breast cancer mortality.

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