Advances in Breast Cancer – Looking Back over the Year

Lüftner, Diana; Lux, Michael P.; Maass, Nicolaì; Schütz, Florian; Schwidde, Ilka; Fasching, Peter A.; Fehm, Tanja; Janni, Wolfgang; Kümmel, Sherko; Kolberg, Hans‐Christian

doi:10.1055/s-0032-1328084

Cited by 21 publications

(15 citation statements)

References 42 publications

(68 reference statements)

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“…Only a small number of patients with breast cancer receive treatment in clinical trials in Germany. At the same time, clinical studies of breast cancer patients have led to considerable successes in recent years [17,18]. The road from routinely performed mastectomy procedures with axillary lymphadenectomy to the current standard of surgical restraint and individualized systemic therapy with its associated dramatic decrease in mortality has been a long one, hedged around by many carefully prepared clinical trials [1,2,19,20].…”

Section: Participation In the Success-a Trial Improves Intensity And mentioning

confidence: 99%

Participation in the SUCCESS-A Trial Improves Intensity and Quality of Care for Patients with Primary Breast Cancer

Andergassen

Kasprowicz

Hepp

et al. 2013

Geburtsh Frauenheilk

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!The SUCCESS-A trial is a prospective, multicenter, phase III clinical trial for high-risk primary breast cancer. It compares disease-free survival after randomization in patients treated with fluorouracil, epirubicin and cyclophosphamide followed by 3 cycles of docetaxel (FEC-D) with that of patients treated with 3 cycles of FEC followed by 3 cycles of gemcitabine and docetaxel (FEC-DG). After a second randomization patients were treated with zoledronate for 2 or 5 years. A total of 251 centers took part in the trial and 3754 patients were recruited over a period of 18 months which ended in March 2007. In a questionnaire-based survey we investigated the impact of enrollment in the trial on patient care, the choice of chemotherapy protocol and access to current oncologic information as well as overall satisfaction in the respective centers. Analysis of the 78 questionnaires returned showed that 40% of the centers had never previously enrolled patients with these indications in clinical studies. Prior to participating in the study, 4 % of the centers prescribed CMF or other protocols in patients with high-primary breast cancer risk, 46 % administered anthracycline-based chemotherapy and 50 % gave taxanebased chemotherapy. Around half of the participating centers noted that intensity of care and overall quality of care became even better and that access to breast cancer-specific information improved through participation in the trial. After their experience with the SUCCESS-A trial, all of the centers stated that they were prepared to enroll patients in clinical phase III trials again in the future. These data indicate that both patients and physicians benefit from clinical trials, as enrollment improves treatment strategies and individual patient care, irrespective of study endpoints. Monaten. Die Auswirkungen der Studienteilnahme auf die Behandlungs-und Versorgungssituation sollten durch einen an die Studienzentren versandten Fragebogen erfasst werden. Nach Auswertung der 78 zurückgesandten Fragebögen zeigte sich, dass 40 % der Zentren ihre Patientinnen zuvor nicht in klinische Studien eingebracht hatten. 4 % verabreichten in einer HighRisk-Situation vor Studienteilnahme CMF-oder ein anderes nicht näher gekennzeichnetes Protokoll. 46% indizierten eine anthrazyklinbasierte und 50% eine taxanbasierte Chemotherapie. Die Hälfte der Zentren bemerkten eine größere Betreuungsintensität und eine Verbesserung der Gesamtqualität der medizinischen Betreuungunabhängig von der rein studienbedingten Zuwendung -sowie einen großen Informationszugewinn durch die Integration in das Studiennetzwerk. Alle Zentren würden nach den Erfahrungen im Rahmen der SUCCESS-A-Studie wieder an einer klinischen Phase-III-Studie teilnehmen. Diese Daten geben einen Hinweis darauf, dass Patientinnen und Ärzte von der Teilnahme an einer Studienteilnahme profitieren, da unabhängig von der erhofften studienspezifischen Therapieverbesserung eine bessere Behandlungsqualität erreicht werden kann.

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Section: Participation In the Success-a Trial Improves Intensity And mentioning

confidence: 99%

Participation in the SUCCESS-A Trial Improves Intensity and Quality of Care for Patients with Primary Breast Cancer

Andergassen

Kasprowicz

Hepp

et al. 2013

Geburtsh Frauenheilk

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“…The incidence of breast cancer has increased in Germany over the last decade, while the mortality has decreased . While the increase in the incidence is mainly attributable to mammography screening, reasons for the decrease in the mortality rate may include mammography screening, early detection, improvements in the available treatments, and the introduction of quality‐assured health care for breast cancer patients . This article is concerned with estimating the probability of a tumor being visible on ultrasound but not on mammography in hospital‐based diagnostic mammography units, focusing on mammographic density and other predictors.…”

mentioning

confidence: 99%

Mammographic density is the main correlate of tumors detected on ultrasound but not on mammography

Häberle

Fasching

Brehm

et al. 2016

Intl Journal of Cancer

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Although mammography screening programs do not include ultrasound examinations, some diagnostic units do provide women with both mammography and ultrasonography. This article is concerned with estimating the risk of a breast cancer patient diagnosed in a hospital-based mammography unit having a tumor that is visible on ultrasound but not on mammography. A total of 1,399 women with invasive breast cancer from a hospital-based diagnostic mammography unit were included in this retrospective study. For inclusion, mammograms from the time of the primary diagnosis had to be available for computer-assisted assessment of percentage mammographic density (PMD), as well as Breast Imaging Reporting and Data System (BIRADS) assessment of mammography. In addition, ultrasound findings were available for the complete cohort as part of routine diagnostic procedures, regardless of any patient or imaging characteristics. Logistic regression analyses were conducted to identify predictors of mammography failure, defined as BIRADS assessment 1 or 2. The probability that the visibility of a tumor might be masked at diagnosis was estimated using a regression model with the identified predictors. Tumors were only visible on ultrasound in 107 cases (7.6%). PMD was the strongest predictor for mammography failure, but age, body mass index and previous breast surgery also influenced the risk, independently of the PMD. Risk probabilities ranged from 1% for a defined low-risk group up to 40% for a high-risk group. These findings might help identify women who should be offered ultrasound examinations in addition to mammography.

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“…These figures show that documentation and quality assurance for breast cancer patients are extremely relevant for healthcare policies and health economics. Documentation and quality assurance are increasingly central for health economics, both nationally and internationally, and it is important that further studies on these topics are carried out [3]. German healthcare policies have also recognized the importance of obtaining more detailed information and have begun to focus more on this aspect.…”

mentioning

confidence: 99%

Time and Resources Needed to Document Patients with Breast Cancer from Primary Diagnosis to Follow-up – Results of a Single-center Study

Lux

Sell

Fasching

et al. 2014

Geburtshilfe Frauenheilkd

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!Aim: Certification of breast centers helps improve the quality of care but requires additional resources, particularly for documentation. There are currently no published data on the actual staff costs and financial resources required for such documentation. The aim of this study was to determine the time and resources required to document a patient with primary breast cancer from diagnosis to the end of follow-up, to establish a database for future strategic decisions. Material and Methods: All diagnostic and therapeutic procedures of patients with primary breast cancer were recorded at the University Breast Center of Franconia. All time points for documentation were evaluated using structured interviews. The times required to document a representative number of patients were determined and combined with the staff costs of the different professional groups, to calculate the financial resources required for documentation. Results: A total of 494 time points for documentation were identified. The study also identified 21 departments and 20 different professional groups involved in the documentation. The majority (54 %) of documentation was done by physicians. 62 % of all documentation involved outpatients. The results of different scenarios for the diagnosis, therapy and follow-up of breast cancer patients in a certified breast center showed that the time required for documentation can be as much as 105 hours, costing € 4135. Conclusion: This analysis shows the substantial staffing and financial costs required for documentation in certified centers. A multi-center study will be carried out to compare the costs for certified breast centers of varying sizes with the costs of non-certified care facilities. Zusammenfassung

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Advances in Breast Cancer – Looking Back over the Year

Cited by 21 publications

References 42 publications

Participation in the SUCCESS-A Trial Improves Intensity and Quality of Care for Patients with Primary Breast Cancer

Participation in the SUCCESS-A Trial Improves Intensity and Quality of Care for Patients with Primary Breast Cancer

Mammographic density is the main correlate of tumors detected on ultrasound but not on mammography

Time and Resources Needed to Document Patients with Breast Cancer from Primary Diagnosis to Follow-up – Results of a Single-center Study

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