Survival of breast cancer patients receiving adjunctive psychosocial support therapy: a 10-year follow-up study.

PURPOSE The impact of an adjunctive psychosocial support program on length of survival with breast cancer was evaluated in a retrospective cohort study. The duration of observation of survival was extended 10 years beyond a previous study of the same cohort of patients. PATIENTS AND METHODS One hundred two nonparticipants were individually matched to 34 participants on major prognostic factors. Both groups were monitored from the date of cancer diagnosis (1971 through 1980) until March 1991. The support program consisted of weekly cancer peer support and family therapy, individual counseling, and use of positive mental imagery. Survival analysis controlled for the effects of other major prognostic factors in the outcome of breast cancer. RESULTS The mean +/- SD survival time from date of cancer diagnosis to last date of follow-up was 96.0 +/- 53.2 months in the participant group compared with 85.1 +/- 63.4 months in the nonparticipant group, a nonsignificant difference (P = .1). Median survival was 84.0 months for participants (95% confidence interval [CI], 59 to 133) and 66.0 months for nonparticipants (95% CI, 48 to 105). A second analysis restricted nonparticipants to those who had a survival time > or = that of the matched case at time of entry into the support program. Survival increased to a mean of 101.1 months (median, 105.0; 95% CI, 71 to 132) for nonparticipants and remained unchanged for participants, also a statistically nonsignificant difference (P = .9). CONCLUSION While the program may have beneficial effects on quality of life, this study does not indicate a significant favorable impact on survival with breast cancer or that the program is serving as a social locus for the gathering of exceptional survivors.

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Surgery for primary tumor benefits survival for breast cancer patients with bone metastases: a large cohort retrospective study

BMC Cancer ◽

10.1186/s12885-021-07964-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Zhangheng Huang ◽

Xin Zhou ◽

Yuexin Tong ◽

Lujian Zhu ◽

Ruhan Zhao ◽

...

Keyword(s):

Breast Cancer ◽

Prognostic Factors ◽

Bone Metastases ◽

Cancer Patients ◽

Primary Tumor ◽

Predictive Accuracy ◽

Rank Test ◽

Breast Cancer Patients ◽

Risk Of Death ◽

The Impact

Abstract Background The role of surgery for the primary tumor in breast cancer patients with bone metastases (BM) remains unclear. The purpose of this study was to determine the impact of surgery for the primary tumor in breast cancer patients with BM and to develop prognostic nomograms to predict the overall survival (OS) of breast cancer patients with BM. Methods A total of 3956 breast cancer patients with BM from the Surveillance, Epidemiology, and End Results database between 2010 and 2016 were included. Propensity score matching (PSM) was used to eliminate the bias between the surgery and non-surgery groups. The Kaplan-Meier analysis and the log-rank test were performed to compare the OS between two groups. Cox proportional risk regression models were used to identify independent prognostic factors. Two nomograms were constructed for predicting the OS of patients in the surgery and non-surgery groups, respectively. In addition, calibration curve, receiver operating characteristic (ROC) curve, and decision curve analysis (DCA) were used to evaluate the performance of nomograms. Result The survival analysis showed that the surgery of the primary tumor significantly improved the OS for breast cancer patients with BM. Based on independent prognostic factors, separate nomograms were constructed for the surgery and non-surgery groups. The calibration and ROC curves of these nomograms indicated that both two models have high predictive accuracy, with the area under the curve values ≥0.700 on both the training and validation cohorts. Moreover, DCA showed that nomograms have strong clinical utility. Based on the results of the X-tile analysis, all patients were classified in the low-risk-of-death subgroup had a better prognosis. Conclusion The surgery of the primary tumor may provide survival benefits for breast cancer patients with BM. Furthermore, these prognostic nomograms we constructed may be used as a tool to accurately assess the long-term prognosis of patients and help clinicians to develop individualized treatment strategies.

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Knowing Cancer Diagnosis is a Protective Factor for the Survival of Patients With Breast Cancer : A Retrospective Cohort Study

10.21203/rs.3.rs-105383/v1 ◽

2020 ◽

Author(s):

Chen He ◽

Wenxi Zhu ◽

Yunxiang Tang ◽

Yonghai Bai ◽

Zheng Luo ◽

...

Keyword(s):

Breast Cancer ◽

Cohort Study ◽

Survival Time ◽

Cancer Patients ◽

Cancer Diagnosis ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Breast Cancer Patients ◽

Term Survival ◽

Cox Regression Analysis

Abstract Background: The health burden of breast cancer is rising in China. The effect of informed diagnosis on long-term survival has not been fully understood. This retrospective cohort study aims at exploring the association between early informed diagnosis and survival time in breast cancer patients.Methods: 12,327 breast cancer patients were enrolled between October 2002 and December 2016. Potential factors including knowing cancer diagnosis status, gender, age, clinical-stage, surgical history, the grade of reporting hospital and diagnostic year were registered. We followed up all participants every 6 months until June 2017.Results: By June 2017, 18.04% of the participants died of breast cancer. Both the 3-year and 5-year survival rate of whom knew cancer diagnosis were longer (P<0.001). By stratified analysis, except subgroups of male patients and patients in stage III, patients knowing diagnosis showed a better prognosis in all the other subgroups (P<0.05). By Cox regression analysis, it was showed that not knowing cancer diagnosis was an independent risk factor for survival in breast cancer patients (P<0.001).Conclusions: Being aware of their cancer diagnosis plays a protective role in extending the survival time in breast cancer patients, which suggests medical staff and patients’ families disclose cancer diagnosis to patients timely.

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Secondary Myeloid Neoplasms in Older Women with Breast Cancer after Radiotherapy: A Population-Based Study

Blood ◽

10.1182/blood.v126.23.1676.1676 ◽

2015 ◽

Vol 126 (23) ◽

pp. 1676-1676

Author(s):

Amer M. Zeidan ◽

Jessica B. Long ◽

Rong Wang ◽

James B. Yu ◽

Jane Hall ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Cancer Diagnosis ◽

Research Funding ◽

Breast Cancer Diagnosis ◽

Breast Cancer Patients ◽

Treatment Delivery ◽

Post Surgery ◽

Single Modality

Abstract BACKGROUND: Chemotherapy and combined chemo-radiotherapy are well-documented risk factors for myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML), collectively referred to in this setting as therapy-related myeloid neoplasms (t-MN). While single-modality radiotherapy post-lumpectomy has been shown to reduce local recurrence among breast cancer patients, data regarding the impact on development of t-MN are limited and inconsistent. METHODS: We conducted a retrospective cohort study of elderly female breast cancer patients (aged 67-94 years at diagnosis) who were diagnosed with in situ or stage 1-3 breast cancer between 1/1/2004 and 12/31/2011 using the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER)-Medicare linked database. Eligibility criteria included 1) enrollment in Medicare Parts A and B continuously through death or end of study (12/31/2013); 2) underwent surgery for breast cancer within 9 months of diagnosis; and 3) were not diagnosed with other neoplasms prior to breast cancer diagnosis. Delivery of radiation therapy was ascertained using the Healthcare Common Procedural Coding System codes. In order to be considered a recipient of radiotherapy, the patient had to receive radiotherapy within 9 months of diagnosis and had any treatment delivery code for brachytherapy or ≥ 4 treatment delivery codes for external bream radiotherapy. Competing-risk analysis was used to assess the risk of developing t-MN in radiotherapy-treated patients compared to those treated with surgery alone. Patients were censored at the time of receiving chemotherapy or at development of another malignancy (aside of t-MN) during follow-up. Competing-risk analysis was used to assess the risk of developing secondary MN women who received radiation therapy compared to those who did not. These models included adjustment for breast cancer diagnosis age and year, number of comorbidities, anemia, functional status prior to breast cancer diagnosis and breast cancer stage. RESULTS: A total of 63,543 patients were included in the study. Median follow-up for all participants was 48 months. A total of 32,809 patients (51.6%) received radiotherapy post-surgery while 30,734 patients (48.4%) were not treated with radiotherapy post-surgery. Patients who received radiotherapy had significantly better overall survival than those who did not (median overall survival [OS] 107 vs. 89 months, p<0.001). During follow-up, a total of 167 patients were diagnosed with MDS or AML (89 cases among those who received radiotherapy and 78 among those who did not receive radiotherapy). The median time to develop MDS/AML was 24 months. In the unadjusted model, there was no significantly increased risk of subsequent AML/MDS among breast cancer patients who received single-modality radiotherapy compared to those who underwent surgery alone (hazard ratio [HR] = 1.11, 95% confidence interval [CI]: 0.82-1.51, p=0.49). Similarly, no significant difference in subsequent MDS/AML according to receipt of radiotherapy was observed in the adjusted analysis (HR = 1.16, 95% CI: 0.84-1.59, p=0.36). CONCLUSIONS: Older patients with early breast cancer who were treated with single-modality radiotherapy post-surgery did not have a higher risk of subsequent MDS/AML compared to patients who did not receive radiotherapy, and the overall rate of MN was low.While additional studies with a longer duration of follow-up are warranted, these results suggest that the single-modality radiotherapy administered in the contemporary management of early breast cancer is not a risk factor for t-MN in this population. Disclosures Yu: 21st-Century Oncology LLC: Research Funding. Gore:Celgene: Consultancy, Honoraria, Research Funding. Gross:Johnson and Johnson: Research Funding; Medtronic: Research Funding; 21st-Century Oncology LLC: Research Funding. Ma:Celgene Corp: Consultancy; Incyte Corp: Consultancy. Davidoff:Celgene: Consultancy, Research Funding.

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The impact of patient-related factors on the occurrence of febrile neutropenia in breast cancer patients receiving (neo-)adjuvant chemotherapy with 5-fluorouracil, epirubicin, and cyclofosfamide (FEC) x6 or FEC x3 followed by docetaxel (D) x3.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.1078 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. 1078-1078

Author(s):

Christof Vulsteke ◽

Alena Pfeil ◽

Barbara Brouwers ◽

Matthias Schwenkglenks ◽

Robert Paridaens ◽

...

Keyword(s):

Breast Cancer ◽

Logistic Regression ◽

Regression Analysis ◽

Febrile Neutropenia ◽

Serum Creatinine ◽

Cancer Patients ◽

Breast Cancer Patients ◽

Related Factors ◽

The Impact

1078 Background: Recently we described the impact of genetic variability on severe toxicity in breast cancer patients receiving (neo-) adjuvant FEC chemotherapy (Annals of Oncology 2013, In Press). We now further assessed the impact of a wide range of patient-related factors on FEC toxicity in routine clinical setting. Methods: Patients with early breast cancer receiving (neo-)adjuvant 6 cycles FEC or sequential 3 cycles of FEC and 3 cycles D were retrospectively evaluated through electronic chart review for febrile neutropenia (primary endpoint; CTC 3.0). Age at diagnosis, body mass index, body surface area, number of cycles received, germline genetic polymorphisms, and baseline biochemical variables (white blood cell count, absolute neutrophil count, platelets, aspartate aminotransferase, alanine aminotransferase, total bilirubin and creatinine) were available for most patients (missing data <10%). All patients had follow up for progression free survival (PFS) and overall survival (OS). Multivariate logistic regression analysis was performed including univariate associates of outcome with a p-value <0.25. Results: We identified 1,031 patients treated between 2000-2010 with 6x FEC (n=488) or 3x FEC followed by 3x D (n=543). 174 (16.9%) patients developed febrile neutropenia during FEC. After logistic regression analysis febrile neutropenia was found to be significantly associated with carriers of the rs45511401 variant T-allele in the MRP1 gene found in 12% of patients (p= 0.03, OR1.99, CI 1.07-3.71) and with increasing serum creatinine values (p=0.05 OR 4.58/CI 0.99-20.98); all other investigated patient-related parameters were not retained by the model. At a mean follow up of 5.2 years, the occurrence of febrile neutropenia was not correlated with PFS and OS. Conclusions: In this study, only the baseline level of serum creatinine and germline genetic polymorphisms in the MRP-1 gene were predictive for the occurrence of febrile neutropenia in patients receiving FEC chemotherapy. The occurrence of febrile neutropenia did not seem to impact on outcome.

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The impact of a well breast cancer patient transition model of care on oncologists’ practice.

Journal of Clinical Oncology ◽

10.1200/jco.2018.36.7_suppl.39 ◽

2018 ◽

Vol 36 (7_suppl) ◽

pp. 39-39

Author(s):

Seungree Nam ◽

Julie Gilbert ◽

Jonathan Sussman ◽

Leta Forbes ◽

Victoria Zwicker ◽

...

Keyword(s):

Breast Cancer ◽

Family Physicians ◽

Post Treatment ◽

Transition Model ◽

Breast Cancer Patients ◽

Model Of Care ◽

Early Communication ◽

Practice Methods ◽

The Impact

39 Background: The transitioning of well breast cancer patients, post-treatment, to family physicians is accepted as a safe and effective model of care. Numerous studies have focused on patients’ experience and health outcomes, but research has not examined the experience of oncologists who are practicing in this model of care. The purpose of this research is to explore the impact of a transition model of care on oncologists’ practice. Methods: Purposive sampling was employed to recruit and interview oncologists who have been transitioning patients to family physicians for two or more years. A total of 15 medical and radiation oncologists practicing in Ontario, Canada were interviewed. Data were analyzed using thematic analysis. Results: Most oncologists interviewed were confident that the transitioning of patients to family physicians is safe for many patients post-treatment. Despite some concerns about the feasibility of the model, namely acceptance of the model among patients and family physicians, oncologists perceived that the model enhances efficiency and sustainability of the cancer system. As the volume of patients in follow-up decreased, oncologists saw a variety of impacts including: a reduction in overbooking in their clinics; more new patients able to be seen in consultation each week; more flexibility in their schedules to accept urgent appointments; and an increased ability to spend more time with patients who are dealing with complex issues. For some oncologists, well patient appointments are a rewarding part of their work. Meanwhile, many experience challenges with increased intensity of workload. Oncologists recognize that some patients and family physicians may be reluctant but they believe that early communication with patients about eventual transition, and improved communication with family physicians can enhance the acceptability of this model of care. Conclusions: Oncologists interviewed in this study reported that the time they used to spend with well follow-up patients can now be spent on other activities that contribute to the enhancement of quality of care for cancer survivors and efficiency in the broader cancer system.

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Comparisons of survival time in BRCA-positive patients with metastatic breast cancer using electronic health records (EHRs).

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e13004 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e13004-e13004

Author(s):

Yookyung Christy Choi ◽

Jerzy Edward Tyczynski ◽

Dongmu Zhang

Keyword(s):

Breast Cancer ◽

Metastatic Breast Cancer ◽

Survival Time ◽

Cancer Diagnosis ◽

Systemic Chemotherapy ◽

Metastatic Breast ◽

Breast Cancer Diagnosis ◽

Study Cohort ◽

Breast Cancer Patients ◽

Mutation Status

e13004 Background: BRCA is a hereditary genetic mutation associated with a higher risk of breast cancer at younger age. Generally, BRCA gene testing is done in perceived high-risk individuals, and different management approaches might be considered given the high risk of breast cancer. This study examines treatment outcomes among BRCA-positive, metastatic breast cancer patients with consideration of prophylactic management by using US nationwide EHR data. Methods: This was a retrospective cohort study using Optum EHRs. The study cohort includes female adults who underwent their first systemic chemotherapy for metastatic breast cancer between 2013-2018 with a BRCA positive test result prior to the systemic chemotherapy, with ≥ 6 months baseline period from the chemotherapy. Physicians’ notes captured in Natural Language Processing (NLP) were further used to construct the cohort. Patients were followed from the earliest breast cancer diagnosis date until a censoring event (death or end of observation period). Death information was provided with national death certificate data. Descriptive statistics were used for patient characteristics and a stepwise Cox Proportional Hazard (CPH) regression model was fit to compare survival time. Results: Of 3624 patients included in the cohort, median age at the earliest breast cancer diagnosis is 50 years old (IQR 43-59), and a total of 540 (14.9%) deaths was observed. Prior to systemic chemotherapy, 1430 (39.5%) received mastectomy/lumpsectomy. 571 (15.8%) received hormone therapy prior to systemic chemotherapy. 646 (17.8%) had a clinical record indicating a triple negative breast cancer (TNBC). 2196 (60.6%) received more than 1 line of chemotherapy. Overall median survival days in the study cohort was 3778 days from the earliest breast cancer diagnosis. Median survival days in those with ER/PR positive and with TNBC status were 4150 days and 3124 days, respectively. From the CPH model, age, tumor mutation status, and prior mastectomy/lumpectomy were identified as significant factors; Hazard Ratio (HR) with each 1 year older in age at diagnosis was 1.02 (95% CL 1.01-1.03), that of TNBC vs ER/PR positive status was 2.27 (95% CL 1.87-2.77) and that of those with prior surgery vs without was 0.567 (95% CL 0.457-0.703). Conclusions: This study demonstrated the utility of EHR database for survival analysis. In metastatic breast cancer patients with a known BRCA-positive status, age at the initial diagnosis, tumor mutation status, and prior mastectomy/lumpectomy were significant factors in survival time.

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Postmastectomy internal mammary node radiation in women with breast cancer: a long-term follow-up study

Journal of Radiotherapy in Practice ◽

10.1017/s1460396915000278 ◽

2015 ◽

Vol 14 (4) ◽

pp. 385-393 ◽

Cited By ~ 3

Author(s):

Budhi S. Yadav ◽

Suresh C. Sharma ◽

Sushmita Ghoshal ◽

Rakesh K. Kapoor ◽

Narendra Kumar

Keyword(s):

Breast Cancer ◽

Disease Free Survival ◽

Breast Cancer Patients ◽

Internal Mammary Node ◽

Supraclavicular Fossa ◽

Long Term Follow Up ◽

Internal Mammary ◽

Postmastectomy Radiation Therapy ◽

The Impact

AbstractBackgroundTo observe the impact of internal mammary node irradiation (IMNI) on disease-free survival (DFS) and overall survival (OS) in postmastectomy women with breast cancer.Materials and methodsBetween 1978 and 1996, 153 women with stage II–III breast cancer were treated with postmastectomy radiation therapy (RT) with IMNI. Their clinical, pathological and treatment characteristics were matched with 166 patients without IMNI. The RT dose was 35 Gy to the chest wall and 40 Gy to the supraclavicular fossa and IMN in 15 fractions over 3 weeks with photons. All patients were planned with two-dimensional technique. Adjuvant chemotherapy was administered to 41% and endocrine therapy to 52% of the patients. Symptomatic patients were further assessed for late pulmonary and late cardiac effects.ResultsThe median follow-up period was 203 months (range, 182–224), and the median age was 44 years (range 20–73 years). The IMNI group had significantly more right-sided and inner/central quadrant tumours. Other characteristics were comparable between both the groups. DFS at 15 years with and without IMNI was 64 and 49%, respectively (p=0·0001). On multivariate analysis, IMNI was an independent, positive predictor of DFS [hazard ratio (HR), 2·89;p=0·0001]. Benefit of IMNI on DFS was more apparent in inner/central tumours [HR, 1·48; 95% confidence interval (CI), 1·02–2·88], N2–N3 patients (HR, 1·44; 95% CI, 1·09–2·10) and in those who received chemotherapy (HR, 1·70; 95% CI, 1·07–2·71). OS at 15 years with and without IMNI was 68 and 54%, respectively (p=0·0001). Late pulmonary toxicity was 1·5 versus 1% with and without IMNI, respectively. Late cardiac toxicity was 2·6 versus 1·8% with and without IMNI, respectively.ConclusionsIMNI significantly improved DFS and OS in postmastectomy breast cancer patients. Benefit of IMNI was seen in patients with central/inner tumours and N2–N3 disease. Late cardiopulmonary toxicities were comparable between the two groups.

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The Role of the Psychooncology Team in the Multidisciplinary Team Management of Breast Cancer Patients - From Diagnosis to After Treatment: A Qualitative Study at MISR Cancer Center

Journal of Global Oncology ◽

10.1200/jgo.18.79400 ◽

2018 ◽

Vol 4 (Supplement 2) ◽

pp. 114s-114s

Author(s):

I. Sallam ◽

G. Amira ◽

A. Youssri

Keyword(s):

Breast Cancer ◽

Qualitative Study ◽

Cancer Center ◽

Team Management ◽

Breast Cancer Patients ◽

Group 2 ◽

The Impact ◽

Group 1

Background: According to the cultural and socioeconomic factors, breast cancer patients (BCP) experienced a relatively low health-related quality of life (Qol) during the journey of breast cancer treatment, that influence patient adaptation to the situation from diagnosis to after treatment. And the further effect on either starting the treatment or its continuation. This merited conducting a qualitative study to explore the importance of the psychooncological approach to BCP and the impact on commencing and continuation of treatment and follow-up. Aim: To describe the impact and importance of the psychooncology team in the cancer center and the effect of their approach on the BCP's Qol. Methods: The study involved 114 interviewed participants, excluding patients with wide variety of chronic illnesses, only 91 patients are the focused study group. Of which 11 patients group (1) refused to join the psychooncological approach due to cultural, and socioeconomic issues, and 80 patients group (2) joined and followed up by the team. Both groups are regularly surveyed. Qualitative and quantitative measurements were used. Data were collected as follows, at time of diagnosis, after surgery and after chemo-radiation therapies from group (1) and for group (2) after the psychooncology team management and care. Developing the psychooncology team for the cancer center. 2 psychooncologists, 5 psychoeducating nurses and a group therapy sessions at a world standard levels of care with ethics committee approvals, and caring for patients' privacy. Close follow-up and evaluation of the performance and Qol of our BCP, raising the awareness about psychoeducation and psychological approach importance for BCP that would help them cope with daily life challenges to improve Qol. Results: Category Group N. Diagnosis related depression N. Surgery related depression N. Treatment related depression Free of depression Group (1) No= 11 3 (27%) 2 (18%) 5 (45%) 1 (10%) Group (2) No= 80 12 (15%) 9 (11.3%) 23 (28.7%) 36 (45%) Conclusion: Results indicate that the most critical depressing points is at time of diagnosis and chemo-radiation therapy. Group (2) has positive indication and alternation on the level of Qol and a significant improvement on level of depression when compared with group (1). This study highlighted the importance of psychooncology team in BCPs' survivorship. It also brings to attention the important role of the government, health policy makers and health plans toward enriching all cancer centers with the psychooncology team. To maximize health and health care for BCP.

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Comparison of various breast cancer detection methods with survival rates

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.17033 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 17033-17033

Author(s):

S. Misra ◽

S. Tarr ◽

D. Pratt

Keyword(s):

Breast Cancer ◽

Survival Time ◽

Cancer Detection ◽

Survival Rates ◽

Staging System ◽

Breast Cancer Detection ◽

Detection Methods ◽

Breast Cancer Patients ◽

Estrogen Receptor Positivity

17033 Background: The role of mammography (MG) but not of breast self-exam (BSE) and clinical breast exam (CBE) in breast cancer detection and survival is well documented. This study compares the different methods of breast cancer detection and subsequent survival rates, analyzing the differences even within the same stage of the disease. Methods: Retrospective review of 1,259 patients was done using the hospital Tumor Registry data. Only patients with stage I, IIA and IIB are included and were diagnosed between April 1992 to December 2005 with follow up ranging from June 1993 to August 2006. The detection methods studied include BSE, CBE, MG and ultrasonography (USG). Parametric tests were conducted. Results: Mean age of the sample was 62 years (range 24–96). There were 293 BSE, 64 CBE, 885 MG, 17 USG detected breast cancer patients. Mean size of mass at presentation was 19 mm (range 1–110). Mean survival time for patients detected with breast cancer till August 2001 was 76 months (range 1–163). 67% patients survived 5 years or more and 12% survived more than 10 years. Mean survival for BSE/CBE and MG/USG group was 43 and 57 months respectively. This difference in survival is significant p< .05; The average survival time by stages I, IIA, IIB for BSE was 47, 45, 38 months, for CBE it was 43, 39, 51 months, for MG it was 57, 59, 50 months and for USG group it was 52, 47, 95 months respectively. Even within the same stage, the method of detection affected survival with the BSE and CBE group having less survival rates (Tukey Test mean difference 0.54, 95% C.I 42–66 and 0.38, 95% C.I 15–61) respectively than the MG group. Survival time also positively correlated with cancer recurrence (r =.7), family history (r = .06) and negatively correlated with age (r = -.09), size of tumor (r = -.09), estrogen receptor positivity status (r = -.06) all with (p < 0.05). We believe this study underestimates overall survival rate as the last follow up date was taken as an end point and also the survival rates are not disease specific survival. Conclusions: MG/USG group show higher survival rates compared to BSE/CBE across the early stages of breast cancer. Even within the same stage, the method of detection affects survival with MG/USG detected cases having more favorable outcomes. May be our current staging system for breast cancer is inadequate and needs revision. No significant financial relationships to disclose.

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Changes in physical activity from pre-diagnosis to first five years post-diagnosis: A prospective cohort study in Chinese breast cancer patient.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e24121 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e24121-e24121

Author(s):

Yuanyuan Lei ◽

Winnie Yeo ◽

Suzanne C. Ho ◽

Ashley Chi Kin Cheng ◽

Carol Kwok

Keyword(s):

Breast Cancer ◽

Physical Activity ◽

Cohort Study ◽

Cancer Patients ◽

Cancer Diagnosis ◽

Prospective Cohort ◽

Chinese Women ◽

Breast Cancer Patients ◽

After Cancer

e24121 Background: The diagnosis of cancer can motivate patients to change their physical activity habits. No data has reported level of physical activity before and after breast cancer diagnosis in Chinese women. Methods: In an on-going prospective cohort study which involved 1462 Chinese women with early-stage breast cancer, a validated modified Chinese Baecke questionnaire was used to assess physical activity at baseline, 18-, 36- and 60-month after diagnosis. At baseline, patients recalled their habitual physical activity in the preceding 12 months before cancer diagnosis. At 18-, 36- and 60-month follow-up, patients reported their habitual physical activity over the previous 12 months. The level of physical activity at post-diagnosis was defined as the average value assessed at 18-, 36- and 60-month follow-up. Results: Breast cancer patients significantly increased level of physical activity, with median value of 0.6, 5.3, 4.4 and 3.9 MET-hours/week at baseline, 18-, 36- and 60-month follow-up. The average level of physical activity at post-diagnosis was also significantly higher than that at pre-diagnosis ( P < 0.001), with median value of 5.8 MET-hours/week. However, there was no significant difference between any two follow-ups at post-diagnosis. The proportions of participant who met the exercise recommendation (according to WCRF/AICR, 10 MET-hours/week) were low at pre- and post-diagnosis, being 20.7% and 35.1%, respectively. Compared to pre-diagnosis, most of the patients improved or had no change on level of recreational physical activity at post-diagnosis, with the respective proportion being 48.2% and 43.8%. Multivariate analysis showed that higher increase in physical activity after cancer diagnosis was observed among breast cancer patients who were married or cohabitation, unemployed (compared to full time) and had no comorbidity (compared to patients who had one comorbidity). Conclusions: Chinese breast cancer patients reported significant and long-term changes in physical activity after cancer diagnosis, which was in line with current recommendation. However, the proportion of patients who met the exercise recommendation for cancer survivors was still low. Empowering patients on the importance of durable high level of physical activity in breast cancer survivorship is warranted.

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