Community-Based Use of Chemotherapy and Hormonal Therapy for Early-Stage Breast Cancer: 1987-2000

Harlan, Linda C.; Clegg, Limin X.; Abrams, Jeffrey S.; Stevens, Jennifer; Ballard‐Barbash, Rachel

doi:10.1200/jco.2005.03.5840

Cited by 66 publications

(45 citation statements)

References 7 publications

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“…Also, it can not be excluded that increased public awareness of breast cancer has contributed. Another major change in the management of breast cancer during the last 25 years is the increased use of systemic adjuvant treatment [12][13][14][15], which may have decreased the incidence of metachronous CBC, thus further contributing to the observed incidence pattern.…”

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confidence: 99%

Diagnostic work-up of contralateral breast cancers has not improved over calendar period

Sandberg

Hartman

Edgren

et al. 2010

Breast Cancer Res Treat

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Women who have been treated for breast cancer are typically followed up with regular mammography and palpation, with the aim of detecting recurrences and contralateral breast cancer (CBC). This study aims to investigate if the diagnostic work-up of breast cancer patients has improved over the last 25 years and resulted in earlier diagnoses of CBC. Two population-based cohorts were used; all CBCs in Sweden 1976Sweden -2004Sweden (n: 2932, and all CBCs in Stockholm, Sweden, 1976Sweden, -2005, both cohorts with a maximum of 3 years between the two cancers. Synchronous CBC was defined as two cancers \3 months apart, the remainder was defined as metachronous CBC. We calculated the odds ratio of being diagnosed synchronously, relative to metachronously, using logistic regression, adjusting for whether the second cancer was detected through clinical work-up or not. The odds of synchronous CBC were significantly increased: 1.27 (95% CI, 1.13-1.42) per 5-year period, compared to metachronous, and was not affected by detection mode, but seemed to be explained by adjuvant therapy. The proportion of CBCs detected by clinical work-up did not increase over the study period, and the mean size of the second tumor remained constant. We found an increase in the proportion of synchronous CBCs compared to metachronous, over calendar period, a change that was not associated with clinical work-up, but with adjuvant therapy. This study gives no indications that any improvement in diagnostic work-up of CBC have occurred over the last 25 years.

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confidence: 99%

Diagnostic work-up of contralateral breast cancers has not improved over calendar period

Sandberg

Hartman

Edgren

et al. 2010

Breast Cancer Res Treat

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“…[5][6][7] Screening patterns, 8,9 treatments, 10,11 and the proportion of estrogen receptor (ER) -positive cancers 7,12 also changed. Peto et al 2 attributed breast cancer mortality improvements in the United Kingdom and United States to diagnosis and treatment.…”

Section: Introductionmentioning

confidence: 99%

“…Peto et al 2 attributed breast cancer mortality improvements in the United Kingdom and United States to diagnosis and treatment. Screening patterns and adjuvant therapies changed in response to guidelines, [8][9][10][11] consensus statements, 13-15 and clinical evidence. [16][17][18][19][20] Elaborate models that incorporated data from the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute on breast cancer incidence, survival, and many other factors indicated that both screening and adjuvant treatment contributed to improvements in mortality, but estimates were uncertain.…”

Section: Introductionmentioning

confidence: 99%

“…ER-positive incidence rates have tracked with overall incidence, whereas ER-negative incidence rates have declined. Median L o c a l R e g i o n a l D i s t a n t L o c a l R e g i o n a l D i s t a n t L o c a l R e g i o n a l D i s t a n t 8,9 From special studies in SEER, 10,11 the percentages of women with invasive breast cancer who received adjuvant hormonal therapy and/or chemotherapy in 2000 were approximately 70% at age Ն 70, 78% at age 50 to 69, and 88% at age 50 and younger. However, only approximately 10% of women age Ն 70 years received chemotherapy alone in 2000, compared with 21% at age 50 to 59 and 40% at age less than 50 years.…”

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confidence: 99%

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Improvements in US Breast Cancer Survival and Proportion Explained by Tumor Size and Estrogen-Receptor Status

Park

Anderson

Gail

2015

JCO

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A B S T R A C T PurposeBreast cancer mortality began declining in many Western countries during the late 1980s. We estimated the proportion of improvements in stage-and age-specific breast cancer survival in the United States explained by tumor size or estrogen receptor (ER) status. MethodsWe estimated hazard ratios for breast cancer-specific death from time of invasive breast cancer diagnosis in the National Cancer Institute's Surveillance, Epidemiology, and End Results 9 Registries Database from 1973 to 2010, with and without stratification by tumor size and ER status. ResultsHazards from breast cancer-specific death declined from 1973 to 2010, not only in the first 5 years after diagnosis, but also thereafter. Stratification by tumor size explained less than 17% of the improvements comparing 2005 to 2010 versus 1973 to 1979, except for women age Ն 70 years with local (49%) or regional (38%) disease. Tumor size usually accounted for more of the improvement in the first 5 years after diagnosis than later. Additional adjustment for ER status (positive, negative, or unknown) from 1990 to 2010 did not explain much more of the improvement, except for women age Ն 70 years within 5 years after diagnosis. ConclusionMost stage-specific survival improvement in women younger than age 70 years old is unexplained by tumor size and ER status, suggesting a key role for treatment. In the first 5 years after diagnosis, tumor size contributed importantly for women Ն 70 years old with local and regional stage, and stratification by tumor size and ER status explained even more of the survival improvement among women age Ն 70 years.

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“…19 In the United States introduction of this consensus guideline increased the administration of adjuvant systemic treatment in all early-stage, node-negative, breast cancer patients < 70 years of age, from approximately 70% in 1995% to 80% in 2000. 20 The increased administration of chemotherapy in patients with an adjusted indication over time is in itself not remarkable, but the absence of this trend in patients in whom a geneexpression profile was applied is notable. In the latter group, no significant difference in chemotherapy administration was observed over time.…”

Section: Cancer Epidemiologymentioning

confidence: 99%

Changes over time in the impact of gene‐expression profiles on the administration of adjuvant chemotherapy in estrogen receptor positive early stage breast cancer patients: A nationwide study

Kuijer

Drukker

Elias

et al. 2016

Intl Journal of Cancer

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Ten years ago gene-expression profiles were introduced to aid adjuvant chemotherapy decision making in breast cancer. Since then subsequent national guidelines gradually expanded the indication area for adjuvant chemotherapy. In this nation-wide study the evolution of the proportion of patients with estrogen-receptor positive (ER1) tumors receiving adjuvant chemotherapy in relation to gene-expression profile use in patient groups that became newly eligible for chemotherapy according to national guideline changes over time is assessed. Data on all surgically treated early breast cancer patients diagnosed between 2004-2006 and 2012-2014 were obtained from the Netherlands Cancer Registry. ER1/Her22 patients with tumorcharacteristics making them eligible for gene-expression testing in both cohorts and a discordant chemotherapy recommendation over time (2004 guideline not recommending and 2012 guideline recommending chemotherapy) were identified. We identified 3,864 patients eligible for gene-expression profile use during both periods. Gene-expression profiles were deployed in 5% and 35% of the patients in the respective periods. In both periods the majority of patients was assigned to a low genomic risk-profile (67% and 69%, respectively) and high adherence rates to the test result were observed (86% and 91%, respectively). Without deploying a gene-expression profile 8% and 52% (p <0.001) of the respective cohorts received chemotherapy while 21% and 28% of these patients received chemotherapy when a gene-expression profile was used (p 0.191). In conclusion, in ER1/Her22 early stage breast cancer patients gene-expression profile use was associated with a consistent proportion of patients receiving chemotherapy despite an adjusted guideline-based recommendation to administer chemotherapy.

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Community-Based Use of Chemotherapy and Hormonal Therapy for Early-Stage Breast Cancer: 1987-2000

Cited by 66 publications

References 7 publications

Diagnostic work-up of contralateral breast cancers has not improved over calendar period

Diagnostic work-up of contralateral breast cancers has not improved over calendar period

Improvements in US Breast Cancer Survival and Proportion Explained by Tumor Size and Estrogen-Receptor Status

Changes over time in the impact of gene‐expression profiles on the administration of adjuvant chemotherapy in estrogen receptor positive early stage breast cancer patients: A nationwide study

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