Adjuvant hormone therapy use in early-stage breast cancer patients insured by the New York State Medicaid program.

2011 ◽  
Vol 29 (15_suppl) ◽  
pp. 6031-6031
Author(s):  
R. L. Yung ◽  
M. J. Hassett ◽  
K. Chen ◽  
F. C. Gesten ◽  
P. R. Roohan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
New York ◽  
Hormone Therapy ◽  
Cancer Patients ◽  
Early Stage ◽  
New York State ◽  
Breast Cancer Patients ◽  
Medicaid Program ◽  
Adjuvant Hormone Therapy ◽  
York State

Early-stage breast cancer patients reporting difficulty sleeping, mood issues, or pain are more likely to refuse adjuvant hormone therapy.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e12065-e12065
Author(s):  
Christian A. Thomas
Keyword(s):  
Breast Cancer ◽  
Adjuvant Therapy ◽  
Hormone Therapy ◽  
Cancer Patients ◽  
Adjuvant Treatment ◽  
Early Stage ◽  
Stage I ◽  
Early Stage Breast Cancer ◽  
Breast Cancer Patients ◽  
Adjuvant Hormone Therapy

e12065 Background: Adjuvant hormone therapy is a crucial part of the treatment for patients with early stage breast cancer and an important quality measure for programs such as QOPI and the oncology care model (OCM). However, it is not known which factors influence some patients with early stage breast cancer to decline adjuvant hormone therapy. We hypothesized that specific self-reported symptoms might impact a patient’s decision to accept or decline adjuvant hormone therapy. Methods: Patients with stage 0 or I breast cancer were identified by chart review from 2011-2016 and de-identified. On the day patients received a recommendation for adjuvant treatment the following patient reported outcome measures (PROs) were analyzed: difficulty sleeping (DS), fatigue (F), mood (M such as anxiety and depression), and pain (P) on a 0-4 symptom scale based on CTCAE v. 4. PROs were then linked with a patient’s decision to accept or decline adjuvant therapy. Results: A total of 287 patients with stage 0 (n = 80) or stage I (n = 207) breast cancer were identified. 38 stage O and 103 stage I patients had evaluable PROs on the same day a recommendation for adjuvant hormone therapy was made. Overall 18/38 (47.4%) of stage 0 patients and 90 of 103 (87.4%) of stage I patients accepted adjuvant treatment. Stage 0 patients declining adjuvant therapy reported any grade of PROs: DS (40%, n = 8), F (35%, n = 7), M (35%, n = 7), P (20%, n = 4). Stage 0 patients accepting treatment reported: DS (22%, n = 4), F (44%, n = 8), M (6%, n = 1), P (20%, n = 4). Stage I patients who declined treatment reported: DS (54%, n = 7), F (46%, n = 6), M (38%, n = 5), P (62%, n = 8). Stage I patients accepting treatment reported: DS (41%, n = 37), F (49%, n = 44), M (31%, n = 28), P (36%, n = 32). Conclusions: Early stage breast cancer patients declining adjuvant hormone therapy are more likely to self report symptoms such as difficulty sleeping, mood disturbances (anxiety, depression), and pain than those accepting treatment.

scholarly journals High Intensity of End-of-Life Care Among Adolescent and Young Adult Cancer Patients in the New York State Medicaid Program

Medical Care ◽  
2015 ◽  
Vol 53 (12) ◽  
pp. 1018-1026 ◽  
Author(s):  
Jennifer W. Mack ◽  
Kun Chen ◽  
Francis P. Boscoe ◽  
Foster C. Gesten ◽  
Patrick J. Roohan ◽  
...  
Keyword(s):  
New York ◽  
Young Adult ◽  
Cancer Patients ◽  
End Of Life Care ◽  
New York State ◽  
Adolescent And Young Adult ◽  
Life Care ◽  
Medicaid Program ◽  
York State ◽  
Young Adult Cancer

scholarly journals Sequential Adjuvant Hormone Therapy in Postmenopausal Breast Cancer: Rationale and Clinical Results

2006 ◽  
Vol 21 (2) ◽  
pp. 111-122
Author(s):  
R. Longo ◽  
M.R. D'Andrea ◽  
G. Gasparini
Keyword(s):  
Breast Cancer ◽  
Hormone Therapy ◽  
Early Stage ◽  
Postmenopausal Breast Cancer ◽  
Clinical Results ◽  
Tamoxifen Treatment ◽  
Clinicopathological Parameters ◽  
Breast Cancer Patients ◽  
Adjuvant Hormone Therapy ◽  
Metastatic Setting

For the past 15 years tamoxifen has been the standard adjuvant hormone therapy for women with early-stage breast cancer and estrogen receptor (ER)-positive tumors, irrespective of nodal status and other clinicopathological parameters. Recent studies provided evidence that the optimal duration of tamoxifen treatment is 5 years. Based on the positive clinical results obtained with the administration of aromatase inhibitors (AIs) in the metastatic setting, several controlled clinical trials have evaluated the efficacy and side effects of AIs versus standard tamoxifen also as adjuvant therapy in postmenopausal breast cancer patients. The results of the above studies, suggest a therapeutic advantage of AIs over tamoxifen with regard to relapse-free survival and the risk of metachronous contralateral breast cancer. We review the rationale and the available clinical data on initial or sequential hormone treatment with AIs and we propose a novel scenario for possible therapeutic strategies based on the clinicopathological characteristics of the patients and on the biology of each single tumor.

scholarly journals The early discontinuation of adjuvant hormone therapy is associated with a poor prognosis in Japanese breast cancer patients

Surgery Today ◽  
2013 ◽  
Vol 44 (10) ◽  
pp. 1841-1846 ◽  
Author(s):  
Kenji Taketani ◽  
Eriko Tokunaga ◽  
Nami Yamashita ◽  
Kimihiro Tanaka ◽  
Sayuri Akiyoshi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Hormone Therapy ◽  
Cancer Patients ◽  
Poor Prognosis ◽  
Breast Cancer Patients ◽  
Early Discontinuation ◽  
Adjuvant Hormone Therapy

Second Malignancies After Treatment of Early-Stage Breast Cancer: Lumpectomy and Radiation Therapy Versus Mastectomy

2000 ◽  
Vol 18 (12) ◽  
pp. 2406-2412 ◽  
Author(s):  
Edward Obedian ◽  
Diana B. Fischer ◽  
Bruce G. Haffty
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Hormone Therapy ◽  
Detailed Analysis ◽  
Cancer Patients ◽  
Early Stage ◽  
Contralateral Breast ◽  
Second Malignancies ◽  
Breast Cancer Patients

PURPOSE: To determine the risk of second malignancies after lumpectomy and radiation therapy (LRT), and to compare it with that in a similar cohort of early-stage breast cancer patients undergoing mastectomy without radiation (MAST). PATIENTS AND METHODS: Between January 1970 and December 1990, 1,029 breast cancer patients at our institution underwent LRT. A cohort of 1,387 breast cancer patients who underwent surgical treatment by mastectomy (MAST), and who did not receive postoperative radiation during the same time period, served as a comparison group. Second malignancies were categorized as contralateral breast versus nonbreast. In the cohort of patients undergoing LRT, a detailed analysis was carried out with respect to age, disease stage, smoking history, radiation therapy technique, dose, the use of chemotherapy or hormone therapy, and other clinical and/or pathologic characteristics. RESULTS: As of March 1999, the median follow-up was 14.6 years for the LRT group and 16 years for the MAST group. The 15-year risk of any second malignancy was nearly identical for both cohorts (17.5% v 19%, respectively). The second breast malignancy rate at 15 years was 10% for both the MAST and LRT groups. The 15-year risk of a second nonbreast malignancy was 11% for the LRT and 10% for the MAST group. In the subset of patients 45 years of age or younger at the time of treatment, the second breast and nonbreast malignancy rates at 15 years were 10% and 5% for patients undergoing LRT versus 7% and 4% for patients undergoing mastectomy (P, not statistically significant). In the detailed analysis of LRT patients, second lung malignancies were associated with a history of tobacco use. There were fewer contralateral breast tumors in patients undergoing adjuvant hormone therapy, although this did not reach statistical significance. The adjuvant use of chemotherapy did not significantly affect the risk of second malignancies. CONCLUSION: There seems to be no increased risk of second malignancies in patients undergoing LRT using modern techniques, compared with MAST. Continued monitoring of these patient cohorts will be required in order to document that these findings are maintained with even longer follow-up periods. With nearly 15 years median follow-up periods, however, these data should be reassuring to women who are considering LRT as a treatment option.

Prevalence of early-stage prostate and estrogen receptor positive (ER+) breast cancer patients receiving primary androgen deprivation therapy (ADT) and aromatase inhibitors (AIs) in the United States (U.S.)

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e22126-e22126
Author(s):  
A. Barlev ◽  
M. Yong ◽  
G. Cherkowski ◽  
K. Cetin ◽  
J. Fryzek
Keyword(s):  
Breast Cancer ◽  
Prostate Cancer ◽  
Clinical Practice ◽  
Hormone Therapy ◽  
Cancer Patients ◽  
Early Stage ◽  
Breast Cancer Patients ◽  
Claims Database ◽  
Breast And Prostate Cancer ◽  
The U.S

e22126 Background: AIs and ADT are used to prevent recurrence of breast and prostate cancers but have been shown to accelerate bone loss. We estimated the prevalence of early-stage ER+ breast and prostate cancer patients on hormone therapy in the U.S., as this is not well-described in the literature. Methods: Data from the Surveillance, Epidemiology, and End Results (SEER) Program, published literature, clinical practice, and a large claims database were used. We began with the American Cancer Society's estimated number of new breast and prostate cancer cases for the year 2008. We then assessed the number of patients with localized/regional disease and ER+ tumors and those receiving primary ADT (both chemical and surgical) or AI therapy by applying proportions from SEER, published literature, clinical practice, and the claims database. Using these incident case counts, we calculated the 5-year prevalence using appropriate cohort-specific survival rates to sum the number of new and surviving cases over a 5-year period. Results: The estimated 5-year prevalence of early-stage ER+ breast cancer for women aged ≥50 years in the U.S. was 607,411, of which 293,904 (48.4%) were on AI therapy based on the claims database. However, because this data source was limited to women aged <65 years, we also used estimates from clinical practice to capture AI use for women of all ages. Based on clinical practice, 402,637 (66.3%) to 460,156 (75.8%) of early-stage ER+ breast cancer patients were on AI therapy. For early-stage prostate cancer, the estimated 5-year prevalence for all ages was 1,024,238, of which 141,451 (13.8%) were on primary ADT. However, these figures may underestimate current usage of hormone therapies, as our data and the literature show increasing trends in ADT and AI use for early-stage disease. Conclusions: Based on a combination of population-based data and the published literature, approximately half of all early-stage ER+ breast cancer patients and a modest proportion of early-stage prostate cancer patients are on hormone therapy in the U.S. [Table: see text]

scholarly journals 3365 Treatment Interruptions and Early Discontinuation of Hormone Therapy in Hormone Receptor-Positive Breast Cancer Patients

2019 ◽  
Vol 3 (s1) ◽  
pp. 157-157
Author(s):  
Daqin Mao ◽  
Hong Chang ◽  
Angie Mae Rodday ◽  
Hilal Hachem ◽  
John K. Erban ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Hormone Therapy ◽  
Cancer Patients ◽  
Hormone Receptor ◽  
Treatment Interruption ◽  
Breast Cancer Patients ◽  
Early Discontinuation ◽  
Adjuvant Hormone Therapy ◽  
Hormone Receptor Positive ◽  
Positive Breast Cancer

OBJECTIVES/SPECIFIC AIMS: (1) To evaluate the association of patient and clinical factors with adherence to adjuvant hormone therapy (HT). (2) To examine the association of HT-related symptoms and the extent of remediation with early discontinuation of hormone therapy. METHODS/STUDY POPULATION: Retrospective cohort study of risk factors for interruption and early discontinuation of adjuvant hormone therapy in hormone receptor-positive nonmetastatic breast cancer patients diagnosed between 2009 and 2015. This study will include incident hormone receptor-positive breast cancer patients who initiated their HT and were followed at Tufts MC until Dec 31, 2016. Primary data source is electronic medical records (EMRs) RESULTS/ANTICIPATED RESULTS: The primary outcome of this study is early discontinuation to HT, defined as the first treatment gap of greater than or equal to 180 days following the initiation of HT. Treatment interruption, defined as any patient- or provider-initiated treatment gap of ≥ 2 weeks, will be examined as the secondary endpoint. Any HT-related symptoms occurred during a follow-up interval will be captured and categorized into five major types (i.e., vasomotor, neuropsychological, gastrointestinal, gynecological, and musculoskeletal symptoms). Onset and duration of a HT-related symptom will be recorded. Severity of the symptoms will also be rated by clinical oncologists. Remediations in response to HT- related symptoms will be collected and categorized into to two groups (pharmacological or non-pharmacological) and whether they were patient- or provider-initiated. Response to a remediation is defined as complete relief, partial relied, no relief, or with worsening symptoms. Response to a treatment change (i.e., HT switch or hold) was collected separately but using the same criteria. Analyses will be performed on the association between patient and clinical factors with rates of nonadherence (unplanned treatment interruption and/or early discontinuation) of hormone therapy, respectively. We also will explore whether patients with elevated symptoms and/or incomplete remediation will have earlier discontinuation of hormone therapy. DISCUSSION/SIGNIFICANCE OF IMPACT: Through formal chart review, we will establish a dataset that contains highly detailed information about treatment-emergent symptoms and remediations, which will enable us to quantitatively assess the impact of these treatment factors on adherence to hormone therapy for breast cancer. The in-depth analysis of risk factors associated with nonadherence to hormone therapy will inform development of interventions to improve cancer outcomes.

Meta-analysis of effect of hormone therapies on lipid levels in breast cancer patients.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e18243-e18243
Author(s):  
Hsin-Hui Huang ◽  
Marnie Bertolet ◽  
Emma Barinas-Mitchell ◽  
Brenda Diergaarde ◽  
Chung-Chou Chang
Keyword(s):  
Breast Cancer ◽  
Hormone Therapy ◽  
Cancer Patients ◽  
Randomized Clinical Trials ◽  
Disease Risk ◽  
Meta Analysis ◽  
Cardiovascular Disease Risk ◽  
Breast Cancer Patients ◽  
Lipid Levels ◽  
Adjuvant Hormone Therapy

e18243 Background: Breast cancer (BC) patients with hormone-sensitive tumors often receive adjuvant hormone therapy for an extended period. How this affects lipid levels is not known. This study evaluated the relationship between dyslipidemia, a cardiovascular disease risk factor, and use of adjuvant hormone therapy among breast cancer patients. Methods: Randomized clinical trials for adjuvant hormone treatment in post-menopausal BC patients without residual cancer after primary treatment that reported lipid levels were identified in PubMed and EMBASE (N = 13). Bayesian network meta-analysis for longitudinal data was used to evaluate each drug’s effect on the mean changes in lipid levels from baseline. Key covariates were examined to determine heterogeneity of treatment effects; consistency of estimates was assessed using the arm-based method. Results: Toremifene improved all lipids more than any other hormone drug studied (see Table). Most aromatase inhibitors (AIs) did not significantly impact lipids. Age, baseline lipid value, and prior usage of Tamoxifen modified the drug effects on most lipids. However, these modifications do not change the overall conclusion. Conclusions: Selective estrogen receptor modulators (SERMs) are beneficial to most lipid profiles, but AIs do not have consistent impacts on lipids. Tailoring hormone drug prescriptions based on medical conditions of BC patients is recommended. [Table: see text]

Sign in / Sign up

Export Citation Format

Share Document