followed from the date of breast cancer diagnosis through death or December 31, 2009. Patients were identified as having positive (negative) ER or PR status if the corresponding assay was reported to SEER as positive/elevated (negative/normal). Demographics, initial treatment (surgery or radiation within 4 months of diagnosis), and survival (Kaplan-Meier [KM] survival curves) were evaluated, by ER and PR status. RESULTS: A total of 3210 female Stage IV BC patients (2,417 [75.3%] ERϩ, and 793 [24.7%] ER-) were identified. Of these, 57.5% were ERϩPRϩ, 17.8% were ERϩPR-, 1.4% were ER-PRϩ, and 23.3% were ER-PR-. Age at diagnosis was similar regardless of ER/PR status (mean [SD] 74-77 [6-7] years). Almost one third of patients had radiation (30%) and close to half of patients had surgery (43%) in the first 4 months following diagnosis, with slight variation by ER/PR status. KM survival analyses suggest that ERϩ patients had significantly higher median survival than ER-patients (24 months vs. 9 months, PϽ0.01). Median survival was highest for ERϩPRϩ patients (25 months) followed by ERϩPR-(19 months), ER-PR-(9 months), and ER-PRϩ (7 months). CONCLUSIONS: Among elderly, newly diagnosed Stage IV BC patients, those with ERϩPRϩ status had the best survival outcomes. Further studies of treatment patterns and outcomes by ER and PR status are warranted.
OBJECTIVES:Although breast cancer is the most common cancer among American women, study investigating treatment pattern and costs is limited. This study aims to determine breast cancer treatment patterns and associated health care charges stratified by initial stage at diagnosis. METHODS: Patients were retrieved from the University of Utah Huntsman Cancer Institute (HCI) and the Utah Population Database. We included female patients with age Ն18, having Ն1of breast cancer ICD9-CM codes, providing informative staging data, and with Ն2 encounters during the time period. Matching to the HCI Tumor Registry using ICD-0 histology and site codes validated a primary site breast cancer. Treatment patterns, health care charges, and overall survival were evaluated. RESULTS: Of 495,523 female patients, 3,109 breast cancers were identified. Mean age was 59.9, 54.6, 53.7, and 56.2 years at stage I (nϭ1,310), II (nϭ1,220), III (nϭ425), and IV (nϭ154), respectively. The mean Charlson co-morbidity score (pϽ0.001), the distribution of age (pϽ0.001) and insurance plan types (pϽ0.001) were all significant between the stage groups. Patients diagnosed at stage I, II, and III received surgery as first treatment, then radiation, and chemotherapy. Stage IV patients had the highest proportion of patients utilizing chemotherapy as first treatment, followed decreasing utilization by stages III, II, and I. The largest annualized charges were incurred in stage IV patients ($68,227), followed by decreasing charges by stage III ($38,178), II ($23,214), and I ($14,615). Five year overall survival was 91.15%, 84.43%, 71.76%, and 35.06% for stage I, II, III, and IV patients, respectively. CONCLUSIONS: Data sugge...