To determine the impact of adjuvant treatment with tamoxifen and aromatase inhibitors (AI) on the survival of men with breast cancer. We analyzed 257 male patients with hormone-receptor-positive breast cancer from numerous German population-based cancer registries treated with tamoxifen (N = 207) or aromatase inhibitors (N = 50). The median follow-up was 42.2 (range 2-115) months. Median age at diagnosis was 68 (range 36-91) years. Thirty-seven (17.9 %) patients treated with tamoxifen and 16 (32.0 %) patients treated with AI died (log rank p = 0.007). After the adjustment for the patient's age, tumor size, node status, and tumor grading, the AI treatment was linked to a 1.5-fold increase in risk of mortality compared to tamoxifen (HR 1.55; 95 % CI: 1.13-2.13; p = 0.007). The overall survival in male breast cancer was significantly better after adjuvant treatment with tamoxifen compared to an aromatase inhibitor. Tamoxifen should be considered as the treatment of choice for hormone-receptor-positive male breast cancer.
We evaluated an intervention to increase participant retention and engagement in community practice settings of the Nurse-Family Partnership (NFP), an evidence-based program of nurse home visiting for low-income, first-time parents. Using a quasi-experimental design (six intervention and 11 controls sites that delivered the NFP), we compared intervention and control sites on retention and number of completed home visits during a 10-month period after the intervention was initiated. Nurses at the 5 intervention sites were guided in tailoring the frequency, duration, and content of the visits to participants’ needs. NFP nurses at the control sites delivered the program as usual. At intervention sites, participant retention and completed home visits increased from the pre-intervention to intervention periods, while at control sites these outcomes decreased from the pre-intervention to intervention periods, leading to a significant intervention-control difference in change in participant retention (Hazard Ratio: 0.42, p = .015) and a 1.4 visit difference in change in completed home visits (p<.001, ES = 0.36). We conclude that training nurse home visitors to promote adaptation of program dosage and content to meet families’ needs shows promise as a way to improve participant retention and completed home visits.
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