Clinical presentation of breast cancer: Age, stage, and treatment modalities in a contemporary cohort of Michigan women.

Abstract

1 Background: The U.S. Preventative Services Task Force (USPSTF) revised their breast cancer screening recommendations in 2009 changing their stance on age and frequency of mammography screening to biannual exams starting at age 50. The purpose of this study is to analyze data from a statewide breast cancer registry managed by the Michigan Breast Oncology Quality Initiative (MiBOQI) to determine the impact of these new recommendations on diagnosing and treating breast cancer. Methods: De-identified data were collected on women participating in the MiBOQI registry at seventeen statewide institutions from 2006-2009. Data included method of detection, cancer stage, age at detection, treatment type, and patient demographics. Participants were stratified based on age, and data analyzed using NCSS software (chi-square and t-tests). Results:5903 women with breast cancer with an average age at diagnosis of 59.4 years were included. 65.5% of breast cancers were detected via mammography, 29.8% by palpation, and 4.7% by other methods. In women under 50 years of age, cancers were detected by mammography in 48.3% (69.3% >50yr) and by palpation in 46.1% (24.1% >50yr). Patients with palpable presentations were younger (55.8 yr vs. 61.2 yr; p <0.001). Cancers with a palpable presentation were diagnosed at higher stages (50.0% stage II) than with mammography (52.5% stage I; p<0.001). Breast conservation surgery occurred more frequently than mastectomy (palpation 54.2%; mammography 72.9%, p<0.001) but cancers detected through palpation were more likely to undergo mastectomy procedures. Conclusions: Results of this study validate the importance of annual screening mammography in women older than 50 years, and women aged 40 to 49 years recently omitted from screening guidelines. There was an increased prevalence of palpation for the method of detection in women less than 50 years of age. If screening mammography is omitted in this group, cancers when detected may be of a more advanced stage and result in more mastectomies. This study also supports the use of palpation as a method of detection despite recent recommendations against teaching self breast exams by USPSTF.

Clinico-Pathological study of carcinoma breast in a tertiary care hospital from West Bengal, India: A Cross-Sectional Observational study

“…Some other study found that breast cancer with an average age at diagnosis of 59.4 years. 6 Another study showed that age range was 18 to 82 years, with a mean of 45.17 years. 7 This study showed that maximum patients i.e.…”

Timeliness of Treatment Initiation in Newly Diagnosed Patients With Breast Cancer

“…The timeliness benchmark for surgery measures initiation of surgery within 45 days of the initial diagnosis for patients with surgery recommended as the first treatment. 21,22 The benchmark of adjuvant hormone treatment measures initiation of hormone therapy within 1 year of diagnosis in stage I to III hormone receptorpositive patients 18 years of age and older. The total number (N) and the percentage of evaluable cases meeting and not meeting each benchmark (%) were reported.…”

“…8,10 Many efforts have been made to eliminate delay-related breast cancer disparities, particularly for early stage disease, including establishment of quality benchmarks by several disease-specific consortia and government agencies, such as the National Quality Forum (NQF) [17][18][19][20] and the Michigan Breast Oncology Quality Initiative (MiBOQI). 21,22 Although the timeliness benchmarks have been established for years, few studies have evaluated how current breast cancer care meets these benchmarks. Furthermore, factors associated with meeting the timeliness benchmarks also remain unclear.…”

“…Given the high frequency of surgery and hormone therapy use in the study population, we evaluated 2 timeliness benchmarks, the 45-day time-to-surgery benchmark from diagnosis established by MiBOQI 21,22 and the 1-year time-to-hormone therapy from diagnosis by NQF. [17][18][19][20] Given that breast cancer survival is in part dependent upon the time from diagnosis to treatment, efforts to expedite initiation of breast cancer care have great clinical value.…”