Use of breast-conserving surgery for treatment of stage I and stage II breast cancer.

1998 ◽  
Vol 16 (1) ◽  
pp. 101-106 ◽  
Author(s):  
E Guadagnoli ◽  
J C Weeks ◽  
C L Shapiro ◽  
J H Gurwitz ◽  
C Borbas ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cohort Study ◽  
Surgical Treatment ◽  
Rural Areas ◽  
Medical Records ◽  
Retrospective Cohort ◽  
Early Stage ◽  
Breast Conserving Surgery ◽  
Teaching Hospitals ◽  
Type Of Surgery

PURPOSE To assess the use of breast-conserving surgery in two states reported to differ with respect to surgical treatment of breast cancer. METHODS A retrospective cohort study based on data collected from medical records and patients was performed among 1,514 patients diagnosed with early-stage breast cancer in Massachusetts and 1,061 patients in Minnesota. Patients were identified at 18 randomly selected hospitals in Massachusetts and at 30 hospitals in Minnesota. The rate of breast-conserving surgery in both states and the correlates of breast-conserving surgery among women eligible for the procedure were determined. RESULTS The rate of breast-conserving surgery in both states was much higher than previously reported. Among those eligible for the procedure, nearly 75% underwent breast-conserving surgery in Massachusetts and nearly half did so in Minnesota. Significantly (P < .003) more women who underwent mastectomy in Minnesota (27%) than in Massachusetts (15%) reported that their surgeon did not discuss breast-conserving surgery with them. Among women who underwent mastectomy and who reported being informed of both surgical alternatives, more women (P < .001) in Minnesota (74%) than in Massachusetts (62%) said they ultimately chose mastectomy because their surgeon recommended it. In Massachusetts, women treated at teaching hospitals were twice as likely as other women to undergo breast-conserving surgery. In Minnesota, women over age 70 and those who lived in rural areas were less likely than other women to undergo breast-conserving surgery. CONCLUSION Although the rate of breast-conserving surgery in each state was higher than expected based on earlier reports, the rates differed considerably between states. Additional studies are needed to determine whether variation in practice between geographic areas is due to differences in patients' preferences and values or to surgeons' propensity for one type of surgery based on where they practice.

scholarly journals Surgical treatment choices for breast cancer in Newfoundland and Labrador: a retrospective cohort study

2018 ◽  
Vol 61 (6) ◽  
pp. 377-384 ◽  
Author(s):  
Farah McCrate ◽  
Elizabeth Dicks ◽  
Erin Powell ◽  
Joanne Chafe ◽  
Rebecca Roome ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cohort Study ◽  
Surgical Treatment ◽  
Retrospective Cohort Study ◽  
Newfoundland And Labrador ◽  
Retrospective Cohort ◽  
Treatment Choices

Consultation With a Medical Oncologist Before Surgery and Type of Surgery Among Elderly Women With Early-Stage Breast Cancer

2003 ◽  
Vol 21 (24) ◽  
pp. 4532-4539 ◽  
Author(s):  
Nancy L. Keating ◽  
Mary Beth Landrum ◽  
John Z. Ayanian ◽  
Eric P. Winer ◽  
Edward Guadagnoli
Keyword(s):  
Breast Cancer ◽  
Axillary Dissection ◽  
Elderly Women ◽  
Early Stage ◽  
Breast Conserving Surgery ◽  
Axillary Node ◽  
Medical Oncologist ◽  
Recommended Care ◽  
Definitive Surgery ◽  
Type Of Surgery

Purpose: Prior studies have documented variation in breast cancer treatment and care that does not follow guideline recommendations, particularly for elderly women. We assessed whether consultation with a medical oncologist before surgery was associated with use of definitive surgery, axillary node dissection, and type of surgery. Methods: We conducted a retrospective cohort study of a population-based sample of 9,630 women aged ≥ 66 years diagnosed with breast cancer during 1995 to 1996. We measured the adjusted proportion visiting a medical oncologist before surgery, identified factors associated with such visits, and assessed the association between visits with a medical oncologist and use of definitive surgery (mastectomy or breast-conserving surgery with radiation v breast-conserving surgery without radiation); axillary dissection; and breast-conserving surgery versus mastectomy among women undergoing definitive surgery. Results: Nineteen percent of women visited a medical oncologist before surgery; these women were younger, more often had larger or more poorly differentiated cancers, had more comorbid illnesses, and were treated more often at a teaching hospital (all P < .05). Women who saw a medical oncologist before surgery were more likely than others to undergo definitive surgery (adjusted odds ratio [OR], 1.28; 95% CI, 1.05 to 1.56) and axillary dissection (adjusted OR, 1.44; 95% CI, 1.19 to 1.73), but less likely to undergo breast-conserving surgery among women undergoing definitive surgery (OR, 0.84; 95% CI, 0.75 to 0.95). Conclusion: Elderly women who consulted with a medical oncologist before surgery were more likely to receive guideline-recommended care. Additional research is needed allow a better understanding of the quality and content of discussions that elderly women have with various providers about breast-conserving surgery and mastectomy.

scholarly journals Identifying Clinicopathological Factors Associated with Oncotype DX® 21-Gene Recurrence Score: A Real-World Retrospective Cohort Study of Breast Cancer Patients in Quebec City, Canada

2021 ◽  
Vol 11 (9) ◽  
pp. 858
Author(s):  
Simon Gagnet ◽  
Caroline Diorio ◽  
Louise Provencher ◽  
Cynthia Mbuya-Bienge ◽  
Julie Lapointe ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Early Stage ◽  
Recurrence Score ◽  
Histologic Grade ◽  
Quebec City ◽  
Clinicopathological Factors ◽  
Factors Associated

Gene expression profiling tests such as the Oncotype DX (ODX) 21-gene recurrence score (RS) assay is increasingly used in clinical practice to predict the risk of recurrence and support treatment planning for early-stage breast cancer (BC). However, this test has some disadvantages such as a high cost and a long turnaround time to get results, which may lead to disparities in access. We aim to identify clinicopathological factors associated with ODX RS in women with early-stage BC. We conducted a retrospective cohort study of women identified in the medical database of the Deschênes-Fabia Breast Disease Center of Quebec City University, Canada. Our sample consists of 425 women diagnosed with early-stage BC who have obtained an ODX RS between January 2011 and April 2015. The ODX RS has been categorized into three levels as originally defined: low (0–17), intermediate (18–30), and high (>30). The mean RS was 17.8 (SD = 9.2). Univariate analyses and multinomial logistic regressions were performed to identify factors associated with intermediate and high RS compared with low RS. A total of 237 (55.8%) patients had low RS, 148 (34.8%) had intermediate RS, and 40 (9.4%) had high RS. Women with progesterone receptor (PR)-negative (ORs ranging from 3.51 to 10.34) and histologic grade II (ORs ranging from 3.16 to 23.04) tumors were consistently more likely to have intermediate or high RS than low RS. Similar patterns of associations were observed when the RS was categorised using redefined thresholds from (i.e., from the TAILORx study or dichotomized). This study provides evidence suggesting that histologic grade and PR status are predictive factors for intermediate or high RS in women with early-stage BC. If these results are confirmed in future studies, considering these clinicopathological factors could spare women the need to get such a test before the beginning of a possible adjuvant therapy. This option could be considered in settings where the cost of testing is an issue.

scholarly journals The Outcome on Conservative Surgical Treatment of Adenomyosis

2017 ◽  
pp. 198
Author(s):  
Budi Wiweko ◽  
Ario Legiantuko ◽  
Achmad Kemal ◽  
Gita Pratama ◽  
Herbert Situmorang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Surgical Treatment ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Transvaginal Sonography ◽  
Type Of Surgery

Objective: To understand the outcome on conservative surgical treatment of adenomyosis. Methods: A retrospective cohort study followed for 2 years from 2010 to 2012 of women with adenomyosis were diagnosed by transvaginal sonography and confirmed histologically. Subjects divided into women who were treated by adenomyosis resection (with/without Osada’s technique) and who were underwent hysterectomy. Results: After the surgery, as many as 40 patients (81.63%) did not feel any pain (VAS 0), and 9 patients (18.37%) still felt pain. For the fertility outcome, we had 8 patients (20.51%) getting pregnant naturally without any fertility intervention. Two patients (5.13%) had successfully conceived by IVF. According to the type of surgery, from 8 natural pregnancy, 7 patients (87.50%) was underwent conventional resection of adenomyosis and 1 patients (12.50%) underwent Osada’s procedures. Two patients who were conceived by IVF, both of them were underwent Osada’s resection. Conclusion: Adenomyosis resection both conservative or Osada’s procedures actually has a better outcome for relieving pain; therefore, some patients can still have a child. Keywords: adenomyosis resection, conventional resection, infertility, Osada’s procedure

Use of subcutaneous and intravenous trastuzumab: real-world experience from three hospitals in Sweden

2019 ◽  
Vol 15 (23) ◽  
pp. 2733-2741
Author(s):  
Antonis Valachis ◽  
Marie Sundqvist ◽  
Lena Carlsson ◽  
Bing Li ◽  
Flaminia Chiesa ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cohort Study ◽  
Electronic Medical Records ◽  
Early Breast Cancer ◽  
Real World ◽  
Retrospective Cohort Study ◽  
Medical Records ◽  
Retrospective Cohort ◽  
Her2 Positive ◽  
Real World Setting

Aim: We aimed to describe the use of subcutaneous (sc.) trastuzumab use in a real-world setting. Patients & methods: This retrospective cohort study evaluated electronic medical records of patients with early breast cancer and trastuzumab use from January 2010 to February 2018 in three hospitals in Sweden. Results: In total, 363 patients received trastuzumab during study period. Of these, 217 (59.8%) patients started treatment with sc. trastuzumab and 146 (40.2%) with intravenous trastuzumab. After sc. trastuzumab approval, use of sc. trastuzumab increased from 70.2% in 2014 to 100% in 2017. Since 2013, 34 of 35 (97.4%) patients who started with intravenous trastuzumab switched to sc. formulation. Conclusion: Trastuzumab sc. quickly became the prevailing formulation for treatment in HER2-positive early breast cancer.

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