Receipt of locoregional therapy among young women with breast cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 1100-1100
Author(s):  
Rachel A. Freedman ◽  
Katherine S. Virgo ◽  
Julia Labadie ◽  
Ann H. Partridge ◽  
Nancy Lynn Keating
Keyword(s):  
Breast Cancer ◽  
Young Women ◽  
Breast Conserving Surgery ◽  
National Cancer Data Base ◽  
Locoregional Therapy ◽  
Adjuvant Radiation ◽  
Optimal Care ◽  
Younger Women ◽  
Cancer Data ◽  
To Receive

1100 Background: Although younger women with breast cancer have the most to gain from receipt of optimal care, few data are available regarding their receipt of locoregional breast cancer treatments. Methods: We identified 318,083 women aged 18-64 who were diagnosed with invasive breast cancer at hospitals reporting to the National Cancer Data Base, a large national cancer registry, during 2004-2008. We used multivariable logistic regression to assess the association of patient age with mastectomy vs. breast-conserving surgery (BCS), radiation with BCS, and post-mastectomy radiation (PMRT) with varying indications, adjusting for patient and tumor characteristics, area-level socioeconomic status, and insurance. Results: Overall, 4% of women were aged ≤35 and 7% were aged 36-40. Women aged ≤35 were significantly more likely to have mastectomy than BCS compared with women aged 56-60 (57% vs. 35%, adjusted odds ratio [OR] 1.97; 95% Confidence Interval [CI] 1.87-2.07) but were less likely to receive radiation if BCS was performed (69% vs. 80%, OR 0.77; 95% CI 0.73-0.82). For those who underwent mastectomy, although overall rates of PMRT receipt were low, women aged ≤35 were more likely to receive postmastectomy radiation (PMRT) despite the presence or absence of clinical indications for PMRT (OR 1.11; 95% CI 1.01-1.22 for strong indications, OR 1.71; 95% CI 1.53-1.91 for borderline indications, and OR 1.49; 95% CI 1.28-1.73 for no indications [all vs. ages 56-60]). Conclusions: Young women with breast cancer may not be receiving optimal locoregional therapy. We observed lower odds of radiation after BCS but higher odds of PMRT for young women regardless of indications for PMRT. Efforts are needed to further understand and improve the receipt of appropriate adjuvant radiation therapy among young women to improve their disease-free and overall survival.

Breast Cancer in Young Women

2019 ◽  
Author(s):  
Lisa A Newman
Keyword(s):  
Breast Cancer ◽  
Young Women ◽  
Triple Negative ◽  
Breast Conserving Surgery ◽  
The United States ◽  
Population Based ◽  
Incidence Rates ◽  
Disease Stage ◽  
Locoregional Therapy ◽  
Key Words Breast

The perception that breast cancer in young women is a growing problem in the United States is based on the fact that young women represent a demographic that has enlarged substantially over the past few decades. Population-based data actually reveal relatively stable incidence rates for breast cancer among women in the premenopausal age range. Young women are more likely to be diagnosed with biologically aggressive phenotypes such as triple-negative and HER2/neu-overexpressing breast cancer. Outcomes are optimized by treatment plans focusing on disease stage and targeted to phenotype. Locoregional therapy for breast cancer in young women should be based on patient preferences and disease pattern (as in older patients); young women with breast cancer can be managed safely with breast-conserving surgery. This review contains 3 figures, 2 tables, and 50 references. Key Words: breast cancer, fertility, ovarian suppression, premenopausal, young women; triple negative breast cancer

scholarly journals Breast Cancer Care in California and Ontario: Primary Care Protections Greatest Among the Most Socioeconomically Vulnerable Women Living in the Most Underserved Places

2017 ◽  
Vol 8 (3) ◽  
pp. 127-134 ◽  
Author(s):  
Kevin M. Gorey ◽  
Caroline Hamm ◽  
Isaac N. Luginaah ◽  
Guangyong Zou ◽  
Eric J. Holowaty
Keyword(s):  
Breast Cancer ◽  
Primary Care ◽  
Health Insurance ◽  
Cancer Care ◽  
Primary Care Physicians ◽  
Rate Ratio ◽  
Adjuvant Radiation ◽  
Breast Cancer Care ◽  
Optimal Care ◽  
Cancer Data

Background: Better health care among Canada’s socioeconomically vulnerable versus America’s has not been fully explained. We examined the effects of poverty, health insurance and the supply of primary care physicians on breast cancer care. Methods: We analyzed breast cancer data in Ontario (n = 950) and California (n = 6300) between 1996 and 2000 and followed until 2014. We obtained socioeconomic data from censuses, oversampling the poor. We obtained data on the supply of physicians, primary care and specialists. The optimal care criterion was being diagnosed early with node negative disease and received breast conserving surgery followed by adjuvant radiation therapy. Results: Women in Ontario received more optimal care in communities well supplied by primary care physicians. They were particularly advantaged in the most disadvantaged places: high poverty neighborhoods (rate ratio = 1.65) and communities lacking specialist physicians (rate ratio = 1.33). Canadian advantages were explained by better health insurance coverage and greater primary care access. Conclusions: Policy makers ought to ensure that the newly insured are adequately insured. The Medicaid program should be expanded, as intended, across all 50 states. Strengthening America’s system of primary care will probably be the best way to ensure that the Affordable Care Act’s full benefits are realized.

Disparities in receipt of and time to adjuvant therapy after lumpectomy.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 534-534
Author(s):  
Irene Dankwa-Mullan ◽  
M. Christopher Roebuck ◽  
Joseph Tkacz ◽  
Oluwadamilola Motunrayo Fayanju ◽  
Yi Ren ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Therapy ◽  
Breast Conserving Surgery ◽  
Relative Risk Ratio ◽  
Adjuvant Radiation ◽  
Factors Associated ◽  
Severe Liver Disease ◽  
Insured Patients ◽  
To Receive ◽  
Area Health

534 Background: Adjuvant treatment after breast conserving surgery (BCS) has been shown to improve outcomes, but the degree of uptake varies considerably. We sought to examine factors associated with post-BCS receipt of and time to treatment (TTT) for adjuvant radiation therapy (ART), cytotoxic chemotherapy (ACT) and endocrine therapy (AET) among women with breast cancer. Methods: IBM MarketScan claims data were used to select women diagnosed with non-metastatic invasive breast cancer from 01/01/2012 to 03/31/2018, who received primary BCS without any neoadjuvant therapy, and who had continuous insurance eligibility 60 days post-BCS. Logistic and quantile regressions were used to identify factors associated with receipt of adjuvant therapy (ART, ACT, AET) and median TTT in days for ART (rTTT), ACT (cTTT), and AET (eTTT), respectively, after adjustment for covariates including age, year, region, insurance plan type, comorbidities, and a vector of ZIP3-level measures (e.g., community race/ethnicity-density, education level) from the 2019 Area Health Resource Files. Results: 36,270 patients were identified: 11,996 (33%) received ART only, 4,837 (13%) received ACT only, 3,458 (10 %) received AET only, 5,752 (16%) received both ART and AET, and 9,909 (27%) received no adjuvant therapy within 6 months of BCS. (318) 1% of patients received combinations of either ART, AET or ACT. Relative to having no adjuvant therapy, patients > 80 years were significantly less likely to receive ART only (relative risk ratio [RRR] 0.65), ACT only (RRR 0.05), or combination ART/AET (RRR 0.66) but more likely to receive AET alone (RRR 3.61) (all p < .001). Patients from communities with high proportions of Black (RRR 0.14), Asian (RRR 0.13), or Hispanic (RRR 0.45) residents were significantly less likely to receive combination ART and AET (all p < .001). Having HIV/AIDS (+11 days; p = .01) and residing in highly concentrated Black (+8.5 days; p = .01) and Asian (+12.2 days; p = .04) communities were associated with longer rTTT. Longer cTTT was associated with having comorbidities of cerebrovascular disease (+6.0 days; p < .001), moderate to severe liver disease (+12.3 days; p < .001) and residing in high-density Asian communities (+18.0 days; p < .001). Shorter eTTT (-11.4 days; p = .06) and cTTT (-14.8 days; p < .001) was observed in patients with comorbidities of dementia. Conclusions: Results from this cohort of privately insured patients demonstrate disparities in receipt of post-BCS adjuvant radiation and systemic therapy along multiple demographic dimensions and expose opportunities to promote timely receipt of care.

Breast Cancer in Young Women

2019 ◽  
Author(s):  
Lisa A Newman
Keyword(s):  
Breast Cancer ◽  
Young Women ◽  
Triple Negative ◽  
Breast Conserving Surgery ◽  
The United States ◽  
Population Based ◽  
Incidence Rates ◽  
Disease Stage ◽  
Locoregional Therapy ◽  
Key Words Breast

The perception that breast cancer in young women is a growing problem in the United States is based on the fact that young women represent a demographic that has enlarged substantially over the past few decades. Population-based data actually reveal relatively stable incidence rates for breast cancer among women in the premenopausal age range. Young women are more likely to be diagnosed with biologically aggressive phenotypes such as triple-negative and HER2/neu-overexpressing breast cancer. Outcomes are optimized by treatment plans focusing on disease stage and targeted to phenotype. Locoregional therapy for breast cancer in young women should be based on patient preferences and disease pattern (as in older patients); young women with breast cancer can be managed safely with breast-conserving surgery. This review contains 3 figures, 2 tables, and 50 references. Key Words: breast cancer, fertility, ovarian suppression, premenopausal, young women; triple negative breast cancer

Sign in / Sign up

Export Citation Format

Share Document