The impact of side effects on adherence and persistence with oral anti-cancer agents in women diagnosed with early stage breast cancer: a systematic review of quantitative evidence protocol

PURPOSE: To evaluate the impact of subsequent pregnancy on the prognosis of patients with early breast cancer. PATIENTS AND METHODS: One hundred eight patients who became pregnant after diagnosis of early-stage breast cancer were identified in institutions participating in International Breast Cancer Study Group (IBCSG) studies. Fourteen had relapse of breast cancer before their first subsequent pregnancy. The remaining 94 patients (including eight who relapsed during pregnancy) formed the study group reported here. A comparison group of 188 was obtained by randomly selecting two patients, matched for nodal status, tumor size, age, and year of diagnosis from the IBCSG database, who were free of relapse for at least as long as the time between breast cancer diagnosis and completion of pregnancy for each pregnant patient. Survival comparison used Cox proportional hazards regression models. RESULTS: Overall 5- and 10-year survival percentages (± SE) measured from the diagnosis of early-stage breast cancer among the 94 study group patients were 92% ± 3% and 86% ± 4%, respectively. For the matched comparison group survival was 85% ± 3% at 5 years and 74% ± 4% at 10 years (risk ratio, 0.44; 95% confidence interval, 0.21 to 0.96; P = .04). CONCLUSION: Subsequent pregnancy does not adversely affect the prognosis of early-stage breast cancer. The superior survival seen in this and other controlled series may merely reflect a healthy patient selection bias, but is also consistent with an antitumor effect of the pregnancy.

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PCN55 THE IMPACT OF 21-GENE RT-PCRASSAY ON REAL LIFE TREATMENT DECISIONS IN N−, ER+ EARLY-STAGE BREAST CANCER PATIENTS: IT'S IMPLICATION FOR BUDGET IMPACT ANALYSIS

Value in Health ◽

10.1016/s1098-3015(10)65213-8 ◽

2007 ◽

Vol 10 (6) ◽

pp. A339

Author(s):

A Hammerman ◽

SH Klang ◽

N Liebermann ◽

N Efrat

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Impact Analysis ◽

Budget Impact ◽

Early Stage ◽

Real Life ◽

Treatment Decisions ◽

Early Stage Breast Cancer ◽

Breast Cancer Patients ◽

The Impact

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The role of radiotherapy in elderly women with early-stage breast cancer treated with breast conserving surgery

Tumori Journal ◽

10.1177/0300891618792465 ◽

2018 ◽

Vol 104 (6) ◽

pp. 429-433 ◽

Cited By ~ 1

Author(s):

Mariacarla Valli ◽

Simona Cima ◽

Paola Fanti ◽

Barbara Muoio ◽

Alessandra Vanetti ◽

...

Keyword(s):

Breast Cancer ◽

Overall Survival ◽

Elderly Women ◽

Early Stage ◽

Conservative Surgery ◽

Early Stage Breast Cancer ◽

Axillary Lymph Nodes ◽

Axillary Lymph ◽

Significant Difference ◽

The Impact

Objective: To analyze the impact of adjuvant radiotherapy (RT) on ipsilateral breast recurrence (IBR) and overall survival (OS) in patients older than 69 years with early-stage breast cancer. Methods: From January 2007 to June 2015, we analyzed retrospectively 137 women with estrogen receptor–positive T1–2 invasive breast cancer, with negative axillary lymph nodes, dividing them into 2 subgroups: 70 to 79 years and older than 79 years. Results: After a median follow-up of 43.2 months, the 3-year IBR-free survival in patients treated with surgery plus RT was 98.8% and 92.1% in patients treated with surgery alone, with a significant difference ( p = .01). Radiotherapy did not impact overall survival ( p = .10). A higher percentage of patients aged between 70 and 79 years received RT after conservative surgery if compared with the older subgroup ( p < .01). Conclusions: In elderly women, adjuvant RT reduced the IBR, but did not improve OS.

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A review of the impact of exercise on treatment-related fatigue among patients receiving adjuvant radiotherapy for breast cancer

Journal of Radiotherapy in Practice ◽

10.1017/s1460396918000754 ◽

2019 ◽

Vol 18 (03) ◽

pp. 295-300 ◽

Cited By ~ 2

Author(s):

Fiona McNally ◽

Paul H. Shepherd ◽

Terri Flood

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Adjuvant Radiotherapy ◽

Early Stage ◽

Early Stage Breast Cancer ◽

Pharmacological Intervention ◽

Breast Cancer Patients ◽

Exercise Interventions ◽

Guidance Needs ◽

The Impact

AbstractPurposeTo evaluate the use of exercise in managing fatigue in breast cancer patients undergoing adjuvant radiotherapy. To explore the effectiveness of different exercise practices and explore how optimum management of fatigue might be achieved.MethodA CINAHL (Cumulative Index to Nursing and Allied Health Literature) database search of literature was undertaken and publications screened for retrieval with 24 qualifying for inclusion in the review.ResultsThere is evidence to support various forms of exercise including aerobic, resistance, alternative and combination exercise in the management of fatigue in early stage breast cancer patients undergoing adjuvant radiotherapy. The benefits of exercise for patients with later stage and metastatic disease is less clear and there is a lack of published research related to this category of patient.ConclusionExercise is considered a safe, non-pharmacological intervention for early stage breast cancer patients receiving adjuvant radiotherapy. Further investigation is required into optimum exercise interventions and the effectiveness and viability of supervised and unsupervised models. Patient centred tailored advice and guidance needs to be developed and effectively promoted by therapeutic radiographers in order for patients to fully realise the benefit.

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Toxicity and clinical outcomes of partial breast irradiation (PBI) compared to whole breast irradiation (WBI) for early stage breast cancer: A systematic review and meta-analysis

Annals of Oncology ◽

10.1093/annonc/mdy270.241 ◽

2018 ◽

Vol 29 ◽

pp. viii78-viii79

Author(s):

H. Goldvaser ◽

A. Fyles ◽

D. Shepshelovich ◽

E. Amir ◽

Y. Korzets

Keyword(s):

Breast Cancer ◽

Systematic Review ◽

Clinical Outcomes ◽

Early Stage ◽

Meta Analysis ◽

Early Stage Breast Cancer ◽

Partial Breast Irradiation ◽

Whole Breast Irradiation ◽

Breast Irradiation

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How radiation oncologist accessibility influences treatment choice and quality in early-stage breast cancer: A SEER database analysis.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.6031 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. 6031-6031

Author(s):

Thomas M. Churilla ◽

Patrick E. Donnelly ◽

Christopher A. Peters

Keyword(s):

Breast Cancer ◽

Radiation Therapy ◽

Early Stage ◽

Early Stage Breast Cancer ◽

Partial Mastectomy ◽

Adjuvant Radiation ◽

Seer Database ◽

Radiation Oncologist ◽

Radiation Oncologists ◽

The Impact

6031 Background: Mastectomy and breast conserving therapy (BCT, partial mastectomy and adjuvant radiotherapy) are equivalent in survival for treatment of early stage breast cancer. This study evaluated the impact of radiation oncologist accessibility on choice of mastectomy versus BCT, and the receipt of radiotherapy after BCT. Methods: In the NCI SEER database, breast cancer cases from 2004-2008 were selected with the following criteria: T2N1M0 or less, lobular or ductal histology, and treatment with simple mastectomy or partial mastectomy (+/-) adjuvant radiation. The HRSA Area Resource File was combined to define average radiation oncologist density (ROD, number of radiation oncologists/100K people) by county over the same time period. Tumor characteristics, demographic information, and ROD were evaluated with respect to mastectomy rates and receipt of radiation therapy after BCT in univariate and multivariate analyses. Results: In the 118,961 cases analyzed, mastectomy was performed 33.3% of the time relative to BCT. After adjustment for demographic and tumor variables, the odds of having mastectomy versus BCT were inversely associated with ROD (OR [95% CI] = 0.94 [0.93-0.96]; p<0.001). Adjuvant radiation therapy was not administered in 23.4% of BCT cases. Likewise, the odds of having BCT without adjuvant radiation were inversely associated with ROD (0.96 [0.95-0.98]; p<0.001, table). Conclusions: There was a significant, inverse and linear relationship between ROD and mastectomy rates independent of demographic and tumor variables. An inverse trend was also observed for the omission of radiotherapy after BCT. Access to radiation oncologists was a factor in surgical choice and receiving appropriate BCT in early stage breast cancer. [Table: see text]

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