Killing time: Treatment delay and breast cancer survival

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 6589-6589
Author(s):  
S. Sheinfeld Gorin ◽  
J. E. Heck ◽  
B. Cheng
Keyword(s):  
Breast Cancer ◽  
Cancer Treatment ◽  
Propensity Scores ◽  
Cancer Survival ◽  
Treatment Delay ◽  
Breast Cancer Treatment ◽  
Breast Cancer Survival ◽  
Access To Treatment ◽  
Breast Cancer Death ◽  
Increased Risk

6589 Introduction: Treatment delay is commonly associated with reduced breast cancer survival. Inadequate or delayed follow-up for positive findings is the most common reason for breast cancer-related litigation in the U.S. The United Kingdom has made improvements in the delivery of breast cancer services a priority for resources with the aim of reducing delays. Yet, the evidence for the association of delay and breast cancer survival is mixed. Most studies rely on small, non-representative cohorts, treatment approaches have changed over the time since the the most widely-cited review. Studies cite wide variations in delay, and some research is subject to publication or lead time bias. Aims. The purpose of this study is to examine the influence of 3-month breast cancer treatment delay on survival using a large, longitudinal, population-based dataset to provide more definitive findings. Methods: Subjects were 43,359 female Medicare enrollees age 65 and older who were diagnosed with breast cancer between 1992 and 1999 and identified by the Surveillance, Epidemiology, and End Results (SEER) program for whom treatment delay information could be obtained. Billing claims from inpatient, outpatient and provider visits were used. Mortality from breast cancer was assessed through SEER linkage with death certificates. Using propensity scores to balance the comparison groups, the association between treatment delays of three months or more and cancer survival time were analyzed using Cox proportional hazards models with gamma frailty to account for the clustering effect due to census tract. To account for known predictors of breast cancer survival, in addition to the propensity scores, we adjusted for cancer stage, comorbidity, marital status, tumor characteristics, location, detection by screening or diagnostic mammography, and the average number of health provider visits during the study period. Results: Subjects who had over a three month delay in receiving any treatment had a 34% increased risk of breast cancer death by comparison to women with delays less than three months (adjusted Hazard ratio 1.34, 1.01–1.77). Discussion: Three-month delays in accessing breast cancer treatment have a clear relationship to survival. Rapid access to treatment is recommended for all women with breast cancer. No significant financial relationships to disclose.

Effect of race/ethnicity and treatment delay on breast cancer survival

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 6063-6063
Author(s):  
S. Sheinfeld Gorin ◽  
J. E. Heck ◽  
B. Cheng ◽  
S. Smith
Keyword(s):  
Breast Cancer ◽  
Propensity Score ◽  
Cancer Treatment ◽  
Propensity Score Analysis ◽  
Large Population ◽  
Treatment Delay ◽  
Breast Cancer Treatment ◽  
Treatment Type ◽  
Increased Risk ◽  
Race Ethnicity

6063 Background: Several papers have examined the relationship between treatment delay and survival among patients who are diagnosed with cancer. None has yet relied on a large, population-based dataset to systematically examine survival among women within different ethnic/racial groups who delay breast cancer treatment. Methods: Subjects were 49,865 female Medicare enrollees age 65 and older who were diagnosed with breast cancer between 1992 and 1999 and identified by the Surveillance, Epidemiology, and End Results (SEER) program. Dates of their health care visits were identified through the linkage of SEER with Medicare claims data. Mortality from breast cancer was assessed through linkage with death certificates. Propensity score analyses that compared patients matched according to their propensity to receive treatment were used to balance patient characteristics between treatment groups, as would occur in a randomized clinical trial. Results: A propensity score analysis and a Cox proportional hazards model of survival (with adjustments for ER/PR status, treatment type, race/ethnicity, stage, age, comorbidities, marital status, poverty status, geographic location, and average number of service contacts) revealed that subjects with 1-month delay in the start of treatment had a reduced likelihood of survival (adjusted HR=1.17, 95% CI, 1.06–1.30) relative to those with less delay. Blacks had significantly lessened survival than women in other races/ethnicities (adjusted HR=1.23, 95% CI, 1.00–1.52). Receipt of radiation (adjusted HR=1.45, 95% CI, 1.24–1.69), chemotherapy (adjusted HR=1.73, 95% CI, 1.51–1.99), stage three diagnosis (adjusted HR=1.35, 95% CI, 1.08–1.70), being age 70 or older (adjusted HR=1.24, 95% CI, 1.09–1.41), or having 2 or more comorbidities (adjusted HR=1.47, 95% CI, 1.12–1.92) also predicted reduced survival from breast cancer. Conclusions: One month delay in accessing breast cancer treatment has a clear relationship to reduced survival, particularly among older, later-stage, comorbid black women who receive chemotherapy or radiation. Mechanisms for rapid access to treatment, using both provider- and system-based strategies, are recommended for these women who are at increased risk for breast cancer-related mortality. No significant financial relationships to disclose.

Seroma indicates increased risk of lymphedema following breast cancer treatment: A retrospective cohort study

The Breast ◽  
2017 ◽  
Vol 32 ◽  
pp. 102-104 ◽  
Author(s):  
Navid Mohamadpour Toyserkani ◽  
Mads Gustaf Jørgensen ◽  
Karen Haugaard ◽  
Jens Ahm Sørensen
Keyword(s):  
Breast Cancer ◽  
Cohort Study ◽  
Cancer Treatment ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Breast Cancer Treatment ◽  
Increased Risk

scholarly journals Alcohol Consumption Before and After Breast Cancer Diagnosis: Associations With Survival From Breast Cancer, Cardiovascular Disease, and Other Causes

2013 ◽  
Vol 31 (16) ◽  
pp. 1939-1946 ◽  
Author(s):  
Polly A. Newcomb ◽  
Ellen Kampman ◽  
Amy Trentham-Dietz ◽  
Kathleen M. Egan ◽  
Linda J. Titus ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Alcohol Consumption ◽  
Alcohol Intake ◽  
Cancer Survival ◽  
Breast Cancer Diagnosis ◽  
Breast Cancer Survival ◽  
Disease Specific Survival ◽  
Increased Risk ◽  
Disease Specific

Purpose Alcohol intake is associated with increased risk of breast cancer. In contrast, the relation between alcohol consumption and breast cancer survival is less clear. Patients and Methods We assessed pre- and postdiagnostic alcohol intake in a cohort of 22,890 women with incident invasive breast cancer who were residents of Wisconsin, Massachusetts, or New Hampshire and diagnosed from 198 to 200 at ages 20 to 79 years. All women reported on prediagnostic intake; a subsample of 4,881 reported on postdiagnostic intake. Results During a median follow-up of 11.3 years from diagnosis, 7,780 deaths occurred, including 3,484 resulting from breast cancer. Hazard ratios (HR) and 95% CIs were estimated. Based on a quadratic analysis, moderate alcohol consumption before diagnosis was modestly associated with disease-specific survival (compared with nondrinkers, HR = 0.93 [95% CI, 0.85 to 1.02], 0.85 [95% CI, 0.75 to 0.95], 0.88 [95% CI, 0.75 to 1.02], and 0.89 [95% CI, 0.77 to 1.04] for two or more, three to six, seven to nine, and ≥ 10 drinks/wk, respectively). Alcohol consumption after diagnosis was not associated with disease-specific survival (compared with nondrinkers, HR = 0.88 [95% CI, 0.61 to 1.27], 0.80 [95% CI, 0.49 to 1.32], 1.01 [95% CI, 0.55 to 1.87], and 0.83 [95% CI, 0.45 to 1.54] for two or more, three to six, seven to nine, and ≥ 10 drinks/wk, respectively). Results did not vary by beverage type. Women consuming moderate levels of alcohol, either before or after diagnosis, experienced better cardiovascular and overall survival than nondrinkers. Conclusion Overall alcohol consumption before diagnosis was not associated with disease-specific survival, but we found a suggestion favoring moderate consumption. There was no evidence for an association with postdiagnosis alcohol intake and breast cancer survival. This study, however, does provide support for a benefit of limited alcohol intake for cardiovascular and overall survival in women with breast cancer.

The impact of scaling up access to treatment and imaging modalities on global disparities in breast cancer survival: a simulation-based analysis

2021 ◽  
Vol 22 (9) ◽  
pp. 1301-1311
Author(s):  
Zachary J Ward ◽  
Rifat Atun ◽  
Hedvig Hricak ◽  
Kwanele Asante ◽  
Geraldine McGinty ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Survival ◽  
Scaling Up ◽  
Breast Cancer Survival ◽  
Imaging Modalities ◽  
Access To Treatment ◽  
Simulation Based ◽  
The Impact

scholarly journals Identification of significantly mutated subnetworks in the breast cancer genome

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Rasif Ajwad ◽  
Michael Domaratzki ◽  
Qian Liu ◽  
Nikta Feizi ◽  
Pingzhao Hu
Keyword(s):  
Breast Cancer ◽  
Cancer Treatment ◽  
Cancer Patients ◽  
Target Genes ◽  
Cancer Survival ◽  
Clustering Algorithms ◽  
Molecular Taxonomy ◽  
Breast Cancer Treatment ◽  
Cancer Genome ◽  
Breast Cancer Patients

AbstractRecent studies showed that somatic cancer mutations target genes that are in specific signaling and cellular pathways. However, in each patient only a few of the pathway genes are mutated. Current approaches consider only existing pathways and ignore the topology of the pathways. For this reason, new efforts have been focused on identifying significantly mutated subnetworks and associating them with cancer characteristics. We applied two well-established network analysis approaches to identify significantly mutated subnetworks in the breast cancer genome. We took network topology into account for measuring the mutation similarity of a gene-pair to allow us to infer the significantly mutated subnetworks. Our goals are to evaluate whether the identified subnetworks can be used as biomarkers for predicting breast cancer patient survival and provide the potential mechanisms of the pathways enriched in the subnetworks, with the aim of improving breast cancer treatment. Using the copy number alteration (CNA) datasets from the METABRIC (Molecular Taxonomy of Breast Cancer International Consortium) study, we identified a significantly mutated yet clinically and functionally relevant subnetwork using two graph-based clustering algorithms. The mutational pattern of the subnetwork is significantly associated with breast cancer survival. The genes in the subnetwork are significantly enriched in retinol metabolism KEGG pathway. Our results show that breast cancer treatment with retinoids may be a potential personalized therapy for breast cancer patients since the CNA patterns of the breast cancer patients can imply whether the retinoids pathway is altered. We also showed that applying multiple bioinformatics algorithms at the same time has the potential to identify new network-based biomarkers, which may be useful for stratifying cancer patients for choosing optimal treatments.

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