Diabetes in elderly patients with breast cancer in the United States: An analysis of data from the Surveillance, Epidemiology, and End Results (SEER)–Medicare linked database

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 11050-11050
Author(s):  
C. D. O'Malley ◽  
M. Danese ◽  
K. Lindquist ◽  
R. Griffiths ◽  
M. Gleeson ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Diagnosis ◽  
Index Date ◽  
The United States ◽  
Physician Service ◽  
Diabetic Patients ◽  
Diabetes Incidence ◽  
Breast Cancer Patients ◽  
Increased Risk ◽  
Time Periods

11050 Background: Despite increases in both breast cancer and diabetes, little is known about their co-occurrence. With evidence that cancer and diabetes can reflect related processes such as obesity, understanding the prevalence of diabetes in patients with breast cancer is critical. Methods: Using the SEER-Medicare linked database, 52,977 women newly diagnosed with breast cancer at ages 66+ years during 1998–2002 were identified, and a random sample of Medicare beneficiaries without cancer, matched (1:1) on sex and residence county were selected as a comparison cohort. The occurrence of diabetes was defined as ≥1 hospital or ≥2 physician service claims, and the date of cancer diagnosis served as the index date for the breast cancer patient and her matched cancer-free individual. For both cohorts, diabetes prevalence was measured for the ≥12 months prior to the index date, and incidence was estimated for non-diabetic patients during three time periods after the index date (3 months, 12 months, and overall), with follow-up through 2005. Prevalence and incidence rates (per 1,000 person-years) and their 95% confidence intervals (CI) are standardized to the age and race distribution of the breast cancer group. Results: Rates were higher in breast cancer patients for all time periods, particularly shortly after diagnosis. This pattern of heightened risk immediately following cancer diagnosis held when rates were stratified by age, stage, and race/ethnicity.For both cohorts, diabetes incidence was typically two times greater in Blacks and Hispanics compared to Whites. Conclusions: Older women with breast cancer are at increased risk for diabetes, suggesting that there may be shared biologic pathways such as insulin, INSR, IGF-1, and IGF-1R. [Table: see text] [Table: see text]

scholarly journals Real-world safety of palbociclib in breast cancer patients in the United States: a new user cohort study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Daniel C. Beachler ◽  
Cynthia de Luise ◽  
Aziza Jamal-Allial ◽  
Ruihua Yin ◽  
Devon H. Taylor ◽  
...  
Keyword(s):  
Breast Cancer ◽  
United States ◽  
Pulmonary Embolism ◽  
Cohort Study ◽  
Real World ◽  
The United States ◽  
Elevated Risk ◽  
Breast Cancer Patients ◽  
Increased Risk ◽  
Serious Infections

Abstract Background There is limited real-world safety information on palbociclib for treatment of advanced stage HR+/HER2- breast cancer. Methods We conducted a cohort study of breast cancer patients initiating palbociclib and fulvestrant from February 2015 to September 2017 using the HealthCore Integrated Research Database (HIRD), a longitudinal claims database of commercial health plan members in the United States. The historical comparator cohort comprised patients initiating fulvestrant monotherapy from January 2011 to January 2015. Propensity score matching and Cox regression were used to estimate hazard ratios for various safety events. For acute liver injury (ALI), additional analyses and medical record validation were conducted. Results There were 2445 patients who initiated palbociclib including 566 new users of palbociclib-fulvestrant, and 2316 historical new users of fulvestrant monotherapy. Compared to these historical new users of fulvestrant monotherapy, new users of palbociclib-fulvestrant had a greater than 2-fold elevated risk for neutropenia, leukopenia, thrombocytopenia, stomatitis and mucositis, and ALI. Incidence of anemia and QT prolongation were more weakly associated, and incidences of serious infections and pulmonary embolism were similar between groups after propensity score matching. After adjustment for additional ALI risk factors, the elevated risk of ALI in new users of palbociclib-fulvestrant persisted (e.g. primary ALI algorithm hazard ratio (HR) = 3.0, 95% confidence interval (CI) = 1.1–8.4). Conclusions This real-world study found increased risks of several adverse events identified in clinical trials, including neutropenia, leukopenia, and thrombocytopenia, but no increased risk of serious infections or pulmonary embolism when comparing new users of palbociclib-fulvestrant to fulvestrant monotherapy. We observed an increased risk of ALI, extending clinical trial findings of significant imbalances in grade 3/4 elevations of alanine aminotransferase (ALT).

Risk and cost of anthracycline-induced cardiotoxicity among breast cancer patients in the United States

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 1037-1037
Author(s):  
J. C. Choi ◽  
J. D. Chang ◽  
B. Seal ◽  
M. Tangirala ◽  
C. D. Mullins
Keyword(s):  
Breast Cancer ◽  
Index Date ◽  
Breast Cancer Diagnosis ◽  
The United States ◽  
Coding System ◽  
Breast Cancer Patients ◽  
Common Procedure ◽  
Comorbidity Index ◽  
Cohort Groups ◽  
And Control

1037 Background: Onset of anthracycline-induced cardiotoxicity is well documented. However, information regarding the time of onset varies depending on literature. The purpose of this study was to compare the risk of cardiotoxicity among three cohort groups: anthracycline-containing-chemotherapy (ACC), no-anthracycline-containing-chemotherapy (NACC), and no-chemotherapy (control) groups. Methods: A retrospective cohort study was designed using commercial managed care claims database. Adult subjects (≥18) diagnosed with breast cancer, between January 1, 2002 to December 31, 2005, (index-period) were followed for 24 months. Subjects with a previous cardiotoxic events (CE), breast cancer diagnosis, or anthracycline-use 12-months prior to index date were excluded. Index date was the first chemotherapy claim date for ACC and NACC and non-chemotherapy medication claim date for controls. Cohorts were matched by index date and year of birth. CE was defined based on ICD-9-CM and Healthcare Common Procedure Coding System codes. Risk of CE was evaluated using a logistic model with and without adjusting for confounders. Results: 21,106 subjects were classified as ACC (n = 3,428), NACC (n = 7,125), and controls (n = 10,553). NACC cohort was significantly (p < 0.01) older (mean age: 62 years ±12.5) compared to ACC (53±9.7) or control cohorts (59±12.5). ACC cohort had a higher (p < 0.01) average degree of comorbidity, (1.8±0.8) compared to NACC (1.6±0.9) or control (1.3±0.8) as measured by Charlson comorbidity-index. Higher rates of CE were found within the ACC group compared to NACC and controls as early as month 3 post index-date and remained consistent over 24 months. At month 12 post index-date, 14% (n = 485) of ACC and 5% (n = 381) of NACC had CE compared to 3% (n = 310) of controls. After adjusting for all baseline differences, the odds ratio of CE compared to controls was 3.98 (95% CI: 3.27–4.85), and 1.31 (95% CI: 1.11–1.54) for ACC and NACC cohorts, respectively. The total mean costs were $59,287, $20,528, and $11,600, among ACC, NACC, and control cohorts respectively. Conclusions: Compared to NACC and controls, ACC cohorts had significantly higher risk of cardiotoxic events and seen as early as month 3 post treatment initiation. [Table: see text]

Risk of acute renal failure among breast cancer patients and chemotherapy treatment of breast cancer patients with a history of renal insufficiency in a commercially-insured population in the United States

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e22104-e22104 ◽  
Author(s):  
W. J. Langeberg ◽  
C. D. O'Malley ◽  
C. W. Critchlow ◽  
J. P. Fryzek
Keyword(s):  
Breast Cancer ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Renal Insufficiency ◽  
Cancer Patients ◽  
Cancer Diagnosis ◽  
The United States ◽  
First Year ◽  
Breast Cancer Patients ◽  
History Of

e22104 Background: Risk of acute renal failure (ARF) among breast cancer (BC) patients may increase with nephrotoxic chemotherapy and other exposures, but this risk is not well characterized. Furthermore, among patients who present with renal insufficiencies (RI) at cancer diagnosis, subsequent treatment patterns are not well described. Methods: We performed a retrospective cohort study using a large national commercial claims database. The cohort included all women diagnosed with BC from 2000 to 2007 who were 18–64 years at diagnosis with no history of cancer (n=13,296). We defined a diagnosis of BC as at least one inpatient or two outpatient claims more than 30 days apart with an ICD-9 code of 174. Among patients with no history of RI (n=13,150), we calculated the cumulative incidence (CI) of ARF_the proportion with at least one inpatient or two outpatient claims with an ICD-9 code of 584 or 586 in the first year following cancer diagnosis. Treatment for BC patients with a history of RI (n=146) was also assessed. Results: Among BC patients with no history of RI, 0.3% were diagnosed with ARF within a year after cancer diagnosis. The CI of ARF was higher in patients with metastases: 0.7% for any metastasis, 2.3% for bone metastasis, and 0.1% for no metastasis. The CI of ARF among patients undergoing radiation or mastectomy was similar to the overall rate (0.3%) but was higher in patients receiving nephrotoxic chemotherapy (1.0%) or intravenous bisphosphonates (IV BPs) (2.1%). The CI of ARF was higher in patients with congestive heart failure (1.4%), diabetes (0.9%), and/or hypertension (0.8%) at cancer diagnosis compared to patients without these comorbidities (0.2%). Among BC patients with a history of RI, 7.5% were administered nephrotoxic chemotherapy, 30.1% received potentially nephrotoxic chemotherapy, and 1.4% were given IV BPs. Conclusions: Breast cancer patients who present with comorbidities, develop metastases, or are given nephrotoxic chemotherapy or IV bisphosphonates are at higher risk of acute renal failure in the first year after breast cancer diagnosis. More research is warranted on the treatment of breast cancer patients with a history of renal insufficiency. [Table: see text]

scholarly journals Beetroot and carrot juice increase the risk of thyroid nodules and hypothyroidism in breast cancer patients

2016 ◽  
Vol 11 (3) ◽  
pp. 251-256
Author(s):  
Diana Viorela ARTENE ◽  
◽  
Cristian I. BORDEA ◽  
Mircea D. CROITORU ◽  
Alexandru BLIDARU ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Cancer Diagnosis ◽  
Thyroid Nodules ◽  
De Novo ◽  
Daily Intake ◽  
Carrot Juice ◽  
Breast Cancer Patients ◽  
Increased Risk ◽  
Daily Intakes

After diagnosis, many breast cancer patients start consuming high quantities of beetroot and carrot juice, in the hope of improving the outcome of their treatment. However, these foods are very high in nitrate, which can competitively inhibit the uptake of iodine by the thyroid, potentially leading to hypothyroidism or thyroid nodules. We applied a nitrate and iodine food frequency questionnare (asking about dairy, fish, seafood and iodized salt for iodine intake and spinach, carrots, beetroot, lettuce and arugula for nitrate intake) to 353 ER+/PR±/HER2-luminal A and B breast cancer patients during antiestrogenic treatment. We excluded patients with a thyroid disease diagnosis prior to the cancer diagnosis, smokers, ex-smokers and those with renal disease or bipolar disorder. The only correlations found between dietary intake of iodine and nitrate and the incidence of de novo thyroid nodules were: decreased risk for a daily intake of minimum 250ml dairy; and increased risk for daily intakes of over 200g spinach, 250g carrots or 250g beetroot. The correlations between dietary intake of nitrate and the incidence of de novo hypothyroidism were: decreased risk for a daily intake of iodized salt 2.5g and minimum of 100g fish or 250ml dairy; and increased risk for daily intakes of over 250g carrots or 250g beetroot. The results of this study support the hypothesis that the increased intake of nitrate-rich foods – particularly beetroot and carrot juice – is a risk factor for de novo hypothyroidism or thyroid nodules, after a breast cancer diagnosis.

ER, PR & HER2 Receptor status in recurrent breast cancer: Its relation to age & time of recurrence

2020 ◽  
Vol 22 (1) ◽  
pp. 16-20
Author(s):  
Abu Khaled Muhammad Iqbal ◽  
Nasima Akhter ◽  
Hasan Shahrear Ahmed ◽  
Md Rassell ◽  
AMM Yahia ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Treatment Approach ◽  
Recurrent Breast Cancer ◽  
Breast Cancer Patients ◽  
Her2 Receptor ◽  
Younger Patients ◽  
Receptor Status ◽  
Increased Risk ◽  
Neoplastic Lesions ◽  
Recurrent Breast

Background: Malignant neoplastic lesions of the breast are one of the main causes of cancer death among women. In tumor cells the expression status of Estrogen receptor (ER), progesterone receptor (PR), and c-ERBB2 (HER2/neu) are therapeutically and prognostically important markers affecting the treatment approach, management and prognosis of breast carcinoma. Objective: To explore the relation of receptor status in recurrent breast cancer to age and time of recurrence. Methods: This study was conducted in National Institute of Cancer Research and Hospital (NICRH) and included 81 female patients between 20 to 75 years with recurrent breast cancer. Detection of receptor status of ER +ve/-ve, PR +ve/-ve, Her-2+ve/-ve was based on the immunohistochemistry staining of tissue samples of malignant neoplastic lesions prepared from tissue biopsies of patients with recurrent breast cancer. All the information were recorded through the pre-structured data collection sheet and analyzed. Results: This study showed that most of the recurrent breast cancer patients were Triple negative breast cancer (TNBC) (39.5%) and among them most of them were younger patients. Younger patients with TNBC had increased risk of recurrence. Most of the recurrence occurred within 1-2 years. Conclusion: It can be concluded that the assessment of the expression of these biornarkers in recurrent tumors provides reliable information for the treatment approach of locoregional tumors. Journal of Surgical Sciences (2018) Vol. 22 (1): 16-20

scholarly journals An Exploration of Heart Failure Risk in Breast Cancer Patients Receiving Anthracyclines with or without Trastuzumab in Thailand: A Retrospective Study

2021 ◽  
Vol 11 (3) ◽  
pp. 484-493
Author(s):  
Jukapun Yoodee ◽  
Aumkhae Sookprasert ◽  
Phitjira Sanguanboonyaphong ◽  
Suthan Chanthawong ◽  
Manit Seateaw ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Cancer Patients ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Breast Cancer Patients ◽  
Ventricular Ejection Fraction ◽  
Factors Associated ◽  
Palliative Intent ◽  
Increased Risk

Anthracycline-based regimens with or without anti-human epidermal growth factor receptor (HER) 2 agents such as trastuzumab are effective in breast cancer treatment. Nevertheless, heart failure (HF) has become a significant side effect of these regimens. This study aimed to investigate the incidence and factors associated with HF in breast cancer patients treated with anthracyclines with or without trastuzumab. A retrospective cohort study was performed in patients with breast cancer who were treated with anthracyclines with or without trastuzumab between 1 January 2014 and 31 December 2018. The primary outcome was the incidence of HF. The secondary outcome was the risk factors associated with HF by using the univariable and multivariable cox-proportional hazard model. A total of 475 breast cancer patients were enrolled with a median follow-up time of 2.88 years (interquartile range (IQR), 1.59–3.93). The incidence of HF was 3.2%, corresponding to an incidence rate of 11.1 per 1000 person-years. The increased risk of HF was seen in patients receiving a combination of anthracycline and trastuzumab therapy, patients treated with radiotherapy or palliative-intent chemotherapy, and baseline left ventricular ejection fraction <65%, respectively. There were no statistically significant differences in other risk factors for HF, such as age, cardiovascular comorbidities, and cumulative doxorubicin dose. In conclusion, the incidence of HF was consistently high in patients receiving combination anthracyclines trastuzumab regimens. A reduced baseline left ventricular ejection fraction, radiotherapy, and palliative-intent chemotherapy were associated with an increased risk of HF. Intensive cardiac monitoring in breast cancer patients with an increased risk of HF should be advised to prevent undesired cardiac outcomes.

scholarly journals Anti-seizure medication is not associated with an increased risk to develop cancer in epilepsy patients

2021 ◽  
Author(s):  
Jenny Stritzelberger ◽  
Johannes D. Lang ◽  
Tamara M. Mueller ◽  
Caroline Reindl ◽  
Vivien Westermayer ◽  
...  
Keyword(s):  
Cancer Risk ◽  
Cancer Diagnosis ◽  
Index Date ◽  
Control Group ◽  
Protective Effects ◽  
Promoting Effect ◽  
Increased Risk ◽  
Comorbidity Index ◽  
Preclinical And Clinical Studies ◽  
Risk Of Cancer

Abstract Objective Whether anti-seizure medication (ASM) increases the risk for cancer has been debated for decades. While for some ASM, a carcinoma-promoting effect has been suspected, carcinoma-protective effects have been shown for other ASM. However, the issue remains unresolved as data from preclinical and clinical studies have been inconsistent and contradictory. Methods We collected anonymous patient data from practice neurologists throughout Germany between 2009 and 2018 using the IMS Disease Analyzer database (QuintilesIMS, Frankfurt, Germany). People with epilepsy (PWE) with an initial cancer diagnosis and antiepileptic therapy prior to the index date were 1:1 matched with a control group of PWE without cancer according to age, gender, index year, Charlson Comorbidity Index, and treating physician. For both groups, the risk to develop cancer under treatment with different ASMs was analyzed using three different models (ever use vs. never use (I), effect per one (II) and per five therapy years (III). Results A total of 3152 PWE were included (each group, n = 1,576; age = 67.3 ± 14.0 years). The risk to develop cancer was not significantly elevated for any ASM. Carbamazepine was associated with a decreased cancer risk (OR Model I: 0.699, p < .0001, OR Model II: 0.952, p = .4878, OR Model III: 0.758, p < .0004). Significance Our findings suggest that ASM use does not increase the risk of cancer in epilepsy patients.

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