The impact of a well breast cancer patient transition model of care on oncologists’ practice.

2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 39-39
Author(s):  
Seungree Nam ◽  
Julie Gilbert ◽  
Jonathan Sussman ◽  
Leta Forbes ◽  
Victoria Zwicker ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Family Physicians ◽  
Post Treatment ◽  
Transition Model ◽  
Breast Cancer Patients ◽  
Model Of Care ◽  
Early Communication ◽  
Practice Methods ◽  
The Impact

39 Background: The transitioning of well breast cancer patients, post-treatment, to family physicians is accepted as a safe and effective model of care. Numerous studies have focused on patients’ experience and health outcomes, but research has not examined the experience of oncologists who are practicing in this model of care. The purpose of this research is to explore the impact of a transition model of care on oncologists’ practice. Methods: Purposive sampling was employed to recruit and interview oncologists who have been transitioning patients to family physicians for two or more years. A total of 15 medical and radiation oncologists practicing in Ontario, Canada were interviewed. Data were analyzed using thematic analysis. Results: Most oncologists interviewed were confident that the transitioning of patients to family physicians is safe for many patients post-treatment. Despite some concerns about the feasibility of the model, namely acceptance of the model among patients and family physicians, oncologists perceived that the model enhances efficiency and sustainability of the cancer system. As the volume of patients in follow-up decreased, oncologists saw a variety of impacts including: a reduction in overbooking in their clinics; more new patients able to be seen in consultation each week; more flexibility in their schedules to accept urgent appointments; and an increased ability to spend more time with patients who are dealing with complex issues. For some oncologists, well patient appointments are a rewarding part of their work. Meanwhile, many experience challenges with increased intensity of workload. Oncologists recognize that some patients and family physicians may be reluctant but they believe that early communication with patients about eventual transition, and improved communication with family physicians can enhance the acceptability of this model of care. Conclusions: Oncologists interviewed in this study reported that the time they used to spend with well follow-up patients can now be spent on other activities that contribute to the enhancement of quality of care for cancer survivors and efficiency in the broader cancer system.

scholarly journals NCOG-08. A COMPARISON OF RESPONSE-ASSESSMENT AND DATA VISUALIZATION METHODS FOR CHARACTERIZATION OF TIME-DEPENDENT OUTCOMES FOLLOWING RADIOSURGERY (SRS) FOR BRAIN METASTASES

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii130-ii131
Author(s):  
Tatiana Kashtanova ◽  
Andrew Keller ◽  
Naren Ramakrishna
Keyword(s):  
Breast Cancer ◽  
Brain Metastases ◽  
Cancer Patients ◽  
Response Assessment ◽  
Post Treatment ◽  
Breast Cancer Patients ◽  
The Impact ◽  
Average State

Abstract PURPOSE We compared multiple response assessment and visualization techniques for characterization of post-SRS treatment outcomes in a cohort of breast cancer patients with long median follow-up. METHODS A retrospective IRB-approved review was completed of 75 breast cancer patients treated with SRS for 271 brain metastases with median follow up of 40 months. Tumor dimensions, brain failure events, corticosteroid use, and clinical status were analyzed utilizing RANO-BM, bidimensional product (BDP), and bidimensional sum (BDS) techniques. 46/75 patients were eligible for RANO-BM assessment. Response at each post-treatment assessment were scored as PD, SD, PR, or CR, and the concordance between techniques was determined. A scoring system-based outcome metric labelled ‘average state’ was derived to estimate fractional time/response state by each assessment method. Interactive timeline displays of outcome states were generated. RESULTS The concordance of patient response states was determined using either RANO-BM, BDP or BDS among the 46 eligible patients. The overall mean and median concordance between techniques were 0.82 and 0.83, (range 0.52 – 1). The average state for the patient population post-treatment was 1.98 by RANO-BM, 2.29 by BDP, and 2.19 by BDS. For patients excluded from RANO-BM secondary to lack of measurable disease, the average state was determined to be 2.44 by BDP and 2.35 by BDS. The average state for HER2+ vs. HER2- patients was 2.21 vs. 1.75 by RANO-BM, 2.58 vs. 2 by BDP, and 2.39 vs. 1.99 by BDS. An interactive timeline view was generated to display outcome states utilizing the 3 response assessment techniques, and the impact of inclusion of non-target lesions and variable response parameters was assessed graphically. CONCLUSIONS These results characterize the concordance and the limitations of multiple outcome assessment methodologies in a post-SRS cohort with long median follow-up. The utility of a novel ‘average state’ outcome metric is demonstrated in this cohort.

The impact of patient-related factors on the occurrence of febrile neutropenia in breast cancer patients receiving (neo-)adjuvant chemotherapy with 5-fluorouracil, epirubicin, and cyclofosfamide (FEC) x6 or FEC x3 followed by docetaxel (D) x3.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 1078-1078
Author(s):  
Christof Vulsteke ◽  
Alena Pfeil ◽  
Barbara Brouwers ◽  
Matthias Schwenkglenks ◽  
Robert Paridaens ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Febrile Neutropenia ◽  
Serum Creatinine ◽  
Cancer Patients ◽  
Breast Cancer Patients ◽  
Related Factors ◽  
The Impact

1078 Background: Recently we described the impact of genetic variability on severe toxicity in breast cancer patients receiving (neo-) adjuvant FEC chemotherapy (Annals of Oncology 2013, In Press). We now further assessed the impact of a wide range of patient-related factors on FEC toxicity in routine clinical setting. Methods: Patients with early breast cancer receiving (neo-)adjuvant 6 cycles FEC or sequential 3 cycles of FEC and 3 cycles D were retrospectively evaluated through electronic chart review for febrile neutropenia (primary endpoint; CTC 3.0). Age at diagnosis, body mass index, body surface area, number of cycles received, germline genetic polymorphisms, and baseline biochemical variables (white blood cell count, absolute neutrophil count, platelets, aspartate aminotransferase, alanine aminotransferase, total bilirubin and creatinine) were available for most patients (missing data <10%). All patients had follow up for progression free survival (PFS) and overall survival (OS). Multivariate logistic regression analysis was performed including univariate associates of outcome with a p-value <0.25. Results: We identified 1,031 patients treated between 2000-2010 with 6x FEC (n=488) or 3x FEC followed by 3x D (n=543). 174 (16.9%) patients developed febrile neutropenia during FEC. After logistic regression analysis febrile neutropenia was found to be significantly associated with carriers of the rs45511401 variant T-allele in the MRP1 gene found in 12% of patients (p= 0.03, OR1.99, CI 1.07-3.71) and with increasing serum creatinine values (p=0.05 OR 4.58/CI 0.99-20.98); all other investigated patient-related parameters were not retained by the model. At a mean follow up of 5.2 years, the occurrence of febrile neutropenia was not correlated with PFS and OS. Conclusions: In this study, only the baseline level of serum creatinine and germline genetic polymorphisms in the MRP-1 gene were predictive for the occurrence of febrile neutropenia in patients receiving FEC chemotherapy. The occurrence of febrile neutropenia did not seem to impact on outcome.

Electrochemotherapy for cutaneous metastases in breast cancer: Experience from a designated treatment centre.

2015 ◽  
Vol 33 (28_suppl) ◽  
pp. 48-48
Author(s):  
Shramana Mitul Banerjee ◽  
Jackie Newby ◽  
Shahab Khan ◽  
Virginia Homfray ◽  
Diane Whittaker ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Disease Progression ◽  
Cancer Patients ◽  
Chest Wall ◽  
Chemotherapeutic Agents ◽  
Post Treatment ◽  
Breast Cancer Patients ◽  
Cutaneous Metastases ◽  
Treatment Centre

48 Background: Electrochemotherapy (ECT) combines the administration of poorly permeable chemotherapeutic agents with electroporation. It has been shown to be effective when compared with other treatments. This study assessed how breast cancer patients were benefited and identified potential problems at a designated treatment centre. Methods: This was a single centre prospective study of patients with cutaneous metastases from breast cancer. Patients who fulfilled NICE UK (National Institute Of Clinical Excellence) and local guidelines were treated. Gabapentin was given prior to general anaesthesia. Intravenous Bleomycin 15,000IU/m2 was given as a bolus. Treatment was commenced 8 minutes later with Cliniporator. Electrical pulses were delivered via an electrode inserted through the skin surface. Treatment response, disease progression free duration, post-operative pain and length of in-patient stay (LOS) were recorded. Patients recorded a symptom diary post treatment. Results: 20 treatments were performed in 16 patients from 2011-2015 with 53 separate areas treated. 8 patients had diffuse lesions, 5 had discrete lesions and 3 had both diffuse and discrete areas. 16 patients were being treated with ECT for the first time and 4 patients required 2 treatments. Median LOS was 3 days. Median follow up was 6 months (range 3-12).12 patients had complete response (75%) and 4 patients partial response. There was no disease progression for 6 months or more in 9 patients (56%) and 2 further patients had disease stabilised for 3 months with systemic or cutaneous progression in the remaining patients in 3 months or less. There were no deaths or immediate adverse events from ECT. 5 Patients (31%) with extensive diffuse chest wall disease reported persistent discomfort post treatment requiring extended period of post treatment analgesia. Conclusions: Electrochemotherapy is safe and effective treatment for cutaneous metastases. Appropriate patient selection for treatment, pre-emptive analgesia, post treatment support and follow up is essential in order to maximise the benefits and minimise potential side-effects particularly in extensive chest wall disease.

Using Canadian administrative data to evaluate primary and oncology care of breast cancer patients post-treatment: Subset of the CanIMPACT Study.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 5-5 ◽  
Author(s):  
Mary L McBride ◽  
Patti Groome ◽  
Donna Turner ◽  
Margaret Jorgensen ◽  
Cynthia Kendell ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Primary Care ◽  
Cancer Patients ◽  
Administrative Data ◽  
Cancer Care ◽  
Data Access ◽  
Post Treatment ◽  
Breast Cancer Patients ◽  
Oncology Care

5 Background: CanIMPACT is a multi-provincial Canadian research team funded to identify and address key issues faced by cancer patients and providers at the intersection of primary and specialist oncology care. Canada has national healthcare standards, but provincial/territorial healthcare delivery systems. One facet will use administrative data from the population-based, publicly-funded healthcare system to evaluate issues during pre-diagnosis, treatment, and post-treatment survivorship for breast cancer patients. For the survivorship phase, we aim to conduct the following analyses and compare across provinces: 1) Utilization of physician services overall and by specialty, including oncologists, non-oncology specialists, and primary care; 2) Assessment of adherence to ASCO and Canadian follow-up guideline for breast cancer care, use of surveillance breast imaging, and metastatic investigations; 3) Assessment of adherence to recommended care of chronic illness and preventive care; 4) Quantification of the cost of follow-up overall and by specialty; 5) Comparison of inter- and intra-provincial variation for all outcomes by health administrative region and for vulnerable groups (age ≥ 75 at diagnosis, northern/rural/remote, low income, immigrants), and examine the effect of continuity of primary care and chronic disease on post-treatment care. Methods: Patients will be identified from provincial cancer registries and linked to data extracted from: outpatient physician service claims, hospital inpatient and outpatient data, and cancer facility medical records. Results: Participating provinces have finalized the core questions and detailed protocols, and assessed data comparability. They are in the process of obtaining the required ethics and data access approvals, and data acquisition for processing and analysis. Conclusions: Results will address existing information gaps that can be used to improve transition and care across the cancer care trajectory. Importantly, results will be combined with those of a CanIMPACT qualitative study to inform design of a pragmatic randomized trial focused on improving coordination and quality of care.

scholarly journals Postmastectomy internal mammary node radiation in women with breast cancer: a long-term follow-up study

2015 ◽  
Vol 14 (4) ◽  
pp. 385-393 ◽  
Author(s):  
Budhi S. Yadav ◽  
Suresh C. Sharma ◽  
Sushmita Ghoshal ◽  
Rakesh K. Kapoor ◽  
Narendra Kumar
Keyword(s):  
Breast Cancer ◽  
Disease Free Survival ◽  
Breast Cancer Patients ◽  
Internal Mammary Node ◽  
Supraclavicular Fossa ◽  
Long Term Follow Up ◽  
Internal Mammary ◽  
Postmastectomy Radiation Therapy ◽  
The Impact

AbstractBackgroundTo observe the impact of internal mammary node irradiation (IMNI) on disease-free survival (DFS) and overall survival (OS) in postmastectomy women with breast cancer.Materials and methodsBetween 1978 and 1996, 153 women with stage II–III breast cancer were treated with postmastectomy radiation therapy (RT) with IMNI. Their clinical, pathological and treatment characteristics were matched with 166 patients without IMNI. The RT dose was 35 Gy to the chest wall and 40 Gy to the supraclavicular fossa and IMN in 15 fractions over 3 weeks with photons. All patients were planned with two-dimensional technique. Adjuvant chemotherapy was administered to 41% and endocrine therapy to 52% of the patients. Symptomatic patients were further assessed for late pulmonary and late cardiac effects.ResultsThe median follow-up period was 203 months (range, 182–224), and the median age was 44 years (range 20–73 years). The IMNI group had significantly more right-sided and inner/central quadrant tumours. Other characteristics were comparable between both the groups. DFS at 15 years with and without IMNI was 64 and 49%, respectively (p=0·0001). On multivariate analysis, IMNI was an independent, positive predictor of DFS [hazard ratio (HR), 2·89;p=0·0001]. Benefit of IMNI on DFS was more apparent in inner/central tumours [HR, 1·48; 95% confidence interval (CI), 1·02–2·88], N2–N3 patients (HR, 1·44; 95% CI, 1·09–2·10) and in those who received chemotherapy (HR, 1·70; 95% CI, 1·07–2·71). OS at 15 years with and without IMNI was 68 and 54%, respectively (p=0·0001). Late pulmonary toxicity was 1·5 versus 1% with and without IMNI, respectively. Late cardiac toxicity was 2·6 versus 1·8% with and without IMNI, respectively.ConclusionsIMNI significantly improved DFS and OS in postmastectomy breast cancer patients. Benefit of IMNI was seen in patients with central/inner tumours and N2–N3 disease. Late cardiopulmonary toxicities were comparable between the two groups.

scholarly journals The Role of the Psychooncology Team in the Multidisciplinary Team Management of Breast Cancer Patients - From Diagnosis to After Treatment: A Qualitative Study at MISR Cancer Center

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 114s-114s
Author(s):  
I. Sallam ◽  
G. Amira ◽  
A. Youssri
Keyword(s):  
Breast Cancer ◽  
Qualitative Study ◽  
Cancer Center ◽  
Team Management ◽  
Breast Cancer Patients ◽  
Group 2 ◽  
The Impact ◽  
Group 1

Background: According to the cultural and socioeconomic factors, breast cancer patients (BCP) experienced a relatively low health-related quality of life (Qol) during the journey of breast cancer treatment, that influence patient adaptation to the situation from diagnosis to after treatment. And the further effect on either starting the treatment or its continuation. This merited conducting a qualitative study to explore the importance of the psychooncological approach to BCP and the impact on commencing and continuation of treatment and follow-up. Aim: To describe the impact and importance of the psychooncology team in the cancer center and the effect of their approach on the BCP's Qol. Methods: The study involved 114 interviewed participants, excluding patients with wide variety of chronic illnesses, only 91 patients are the focused study group. Of which 11 patients group (1) refused to join the psychooncological approach due to cultural, and socioeconomic issues, and 80 patients group (2) joined and followed up by the team. Both groups are regularly surveyed. Qualitative and quantitative measurements were used. Data were collected as follows, at time of diagnosis, after surgery and after chemo-radiation therapies from group (1) and for group (2) after the psychooncology team management and care. Developing the psychooncology team for the cancer center. 2 psychooncologists, 5 psychoeducating nurses and a group therapy sessions at a world standard levels of care with ethics committee approvals, and caring for patients' privacy. Close follow-up and evaluation of the performance and Qol of our BCP, raising the awareness about psychoeducation and psychological approach importance for BCP that would help them cope with daily life challenges to improve Qol. Results: Category Group N. Diagnosis related depression N. Surgery related depression N. Treatment related depression Free of depression Group (1) No= 11 3 (27%) 2 (18%) 5 (45%) 1 (10%) Group (2) No= 80 12 (15%) 9 (11.3%) 23 (28.7%) 36 (45%) Conclusion: Results indicate that the most critical depressing points is at time of diagnosis and chemo-radiation therapy. Group (2) has positive indication and alternation on the level of Qol and a significant improvement on level of depression when compared with group (1). This study highlighted the importance of psychooncology team in BCPs' survivorship. It also brings to attention the important role of the government, health policy makers and health plans toward enriching all cancer centers with the psychooncology team. To maximize health and health care for BCP.

Survival of breast cancer patients receiving adjunctive psychosocial support therapy: a 10-year follow-up study.

1993 ◽  
Vol 11 (1) ◽  
pp. 66-69 ◽  
Author(s):  
G A Gellert ◽  
R M Maxwell ◽  
B S Siegel
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Survival Time ◽  
Cancer Diagnosis ◽  
Psychosocial Support ◽  
Support Program ◽  
Breast Cancer Patients ◽  
Nonsignificant Difference ◽  
The Impact

PURPOSE The impact of an adjunctive psychosocial support program on length of survival with breast cancer was evaluated in a retrospective cohort study. The duration of observation of survival was extended 10 years beyond a previous study of the same cohort of patients. PATIENTS AND METHODS One hundred two nonparticipants were individually matched to 34 participants on major prognostic factors. Both groups were monitored from the date of cancer diagnosis (1971 through 1980) until March 1991. The support program consisted of weekly cancer peer support and family therapy, individual counseling, and use of positive mental imagery. Survival analysis controlled for the effects of other major prognostic factors in the outcome of breast cancer. RESULTS The mean +/- SD survival time from date of cancer diagnosis to last date of follow-up was 96.0 +/- 53.2 months in the participant group compared with 85.1 +/- 63.4 months in the nonparticipant group, a nonsignificant difference (P = .1). Median survival was 84.0 months for participants (95% confidence interval [CI], 59 to 133) and 66.0 months for nonparticipants (95% CI, 48 to 105). A second analysis restricted nonparticipants to those who had a survival time > or = that of the matched case at time of entry into the support program. Survival increased to a mean of 101.1 months (median, 105.0; 95% CI, 71 to 132) for nonparticipants and remained unchanged for participants, also a statistically nonsignificant difference (P = .9). CONCLUSION While the program may have beneficial effects on quality of life, this study does not indicate a significant favorable impact on survival with breast cancer or that the program is serving as a social locus for the gathering of exceptional survivors.

scholarly journals Is Adjuvant Tamoxifen Recommended in Post-Menopausal Node-Negative Breast Cancer Patients with High Estrogen Receptor Values?

2000 ◽  
Vol 15 (2) ◽  
pp. 135-138 ◽  
Author(s):  
J.-L. Floiras ◽  
K. Hacene ◽  
F. Turpin ◽  
F. Spyratos
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Disease Free Survival ◽  
Adjuvant Tamoxifen ◽  
Breast Cancer Patients ◽  
Node Negative ◽  
Node Negative Breast Cancer ◽  
Post Menopausal ◽  
The Impact

The impact of ER levels on the response to tamoxifen was evaluated in 1,623 postmenopausal primary breast cancer patients treated at our center (median follow-up 8.2 years). In patients receiving adjuvant tamoxifen a significantly longer disease-free survival (DFS) was observed when ER levels were elevated (p<0.00001). Very high ER (>424 fmol/mg protein) appeared to be detrimental in node-negative patients not treated with tamoxifen.

The impact of 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET) on the decision-making process in breast cancer patients: The experience of Bologna’s S.Orsola-Malpighi Hospital

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 10588-10588
Author(s):  
F. Sperandi ◽  
S. Fanti ◽  
R. Franchi ◽  
A. Martoni
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Cancer Patients ◽  
Fdg Pet ◽  
Therapeutic Strategy ◽  
Disease Stage ◽  
Clinical Approach ◽  
Breast Cancer Patients ◽  
The Impact

10588 Background: 18F-FDG-PET is rapidly spreading “technology” in oncology. Its appropriate use and the clinical settings in which it can modify decision-making need to be defined. Methods: All the requests for 18F-FDG-PET issued by the Medical Oncology Unit are submitted to internal audit. The aim is to evaluate the impact of the information deriving from the test on the subsequent therapeutic strategy in breast cancer patients (pts). From July 2002 to July 2005, 195 18F-FDG-PET examinations were performed in 110 pts. Pt series have been subdivided according to disease stage or clinical setting: Group 1) NED during the follow-up 23 (11.8%); Group 2) suspected first recurrence 52 (26.7%) (included 20 cases with an isolated elevation of CA15.3 and/or CEA serum levels); Group 3) overt metastases: a) single lesion 10 (5.1%), b) multiple lesions with suspected disease progression 26 (13.3%), c) re-evaluation of non-progressive metastatic disease 84 (43.1%). Results: Overall, 18F-FDG-PET was positive in 112 (57.4%) cases: in Groups 1), 2), 3a), 3b) and 3c) positivity was 13%, 63.5%, 60%, 73.1% and 60.7%, respectively. As concerns those pts with an isolated marker serum level increase during the follow-up, 18F-FDG-PET was positive in 13 (65%) cases. Overall, the result of 18F-FDG-PET determined a therapeutic strategy change in 79 (40.5%) cases. This change consisted in a decision to start or re-start anti-tumor medical treatment in 46 (58.2%), to perform or exclude surgery or radiotherapy with a potentially radical purpose in 10 (12.7%), to continue follow-up or to stop treatment in 23 (29.1%). The change of strategy according to Groups 1), 2), 3a), 3b) and 3c) was 13%, 75%, 90%, 61.5% and 14.3%, respectively. Conclusions: A “clinical” approach to the use of 18F-FDG-PET in breast cancer pts allows us to change the decision-making in about 40% of pts. Clinical situations in which 18F-FDG-PET is more useful are in cases of suspected recurrence and oligometastatic disease. No significant financial relationships to disclose.

The impact of epoetin-alpha on anemia, red blood cell (RBC) transfusions, and survival in breast cancer patients (pts) treated with dose-dense sequential chemotherapy: Mature results of an AGO phase III study (ETC trial)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 569-569 ◽  
Author(s):  
V. Moebus ◽  
H. Lueck ◽  
C. Thomssen ◽  
N. Harbeck ◽  
U. Nitz ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Disease Free Survival ◽  
Phase Iii ◽  
Hematological Toxicity ◽  
Transfusion Rate ◽  
Breast Cancer Patients ◽  
Epoetin Alpha ◽  
Dose Dense ◽  
The Impact

569 Background: Dose-dense chemotherapy has been shown to have a significant advantage in disease-free survival (DFS) and overall survival (OS) in high risk breast cancer pts, but leads to a higher number of RBC transfusions (CALGB C9741, AGO-ETC). Controversial results have been reported regarding the influence of Epoetin-alpha on DFS and OS in cancer pts. Methods: From 12/98 until 4/03, 1,284 pts were recruited into a multi-center phase-III trial. Breast cancer pts with at least 4 involved lymph nodes and below 65 years of age were randomized between a standard regimen (4 × EC followed by 4 × Paclitaxel) and a dose-dense arm consisting of three courses each of epirubicin (150 mg/m2), paclitaxel (225 mg/m2) and cyclophosphamide (2,500 mg/m2) at 2 weeks interval (ETC). A second randomization ± Epoetin-alpha was performed in the ETC arm only (150 IU/kg/sc three times weekly). Results: In 10/06, 1255 (98%) pts were evaluable. 658 pts were randomized in the dose-dense ETC arm, of whom 333 received Epoetin-alpha. Median follow- up is 62 months. Anemia was seen significantly more often in the ETC-arm alone compared to treatment with Epoetin-alpha (p<0.0001). Altogether, 11% of all patients were treated with RBC transfusions. Standard EC->T treatment resulted in 1% RBC transfusions, but 28% in the ETC arm alone vs. 13% in the ETC + Epoetin-alpha-arm (p<0.0001) received RBC transfusions. Despite this significantly higher transfusion rate the median Hb-value dropped from 12,8g/dl at cycle 1 to 10,7g/dl at cycle 9 in the ETC arm alone. In contrast the same value remained stable with Epoetin-alpha (12,4g/dl at cycle 1 and 9 each). At a median follow-up of 62 months, there is no difference between the ETC-arm alone and the ETC + Epoetin-alpha-arm concerning 5-year DFS and OS ((71% vs. 72% (p=0.86) and 83% vs. 81% (p=0.89)). Conclusions: The dose-dense adjuvant ETC-regimen significantly improves DFS and OS but is combined with relevant hematological toxicity. Epoetin-alpha significantly reduces the number of RBC transfusions and prevents anemia. However, the prevention of anemia has no influence on DFS and OS in the adjuvant treatment with dose-dense ETC. [Table: see text]

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