Competing causes of death for primary breast cancer

Fish, Edward B.; Chapman, Judy‐Anne W.; Link, Marilyn A.

doi:10.1007/bf02303502

Cited by 37 publications

(23 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Additionally, we included the elderly in our investigations. To do this, we utilized the endpoint of disease-specific death, rather than overall death, since the elderly are more likely to die from a competing cause [22]. The usual practice of considering overall survival in clinical trials would yield approximately the same results as those with DSS if the patients are under 65 years of age at diagnosis, since most of those patients will die from breast cancer [22,33].…”

Section: Discussionmentioning

confidence: 99%

“…With this cohort, we found that overall survival was significantly impacted by the age of the patient at diagnosis ( p < 0.001), mainly from competing causes of death. Different factors impact overall survival compared to survival from breast cancer [22]. The focus here was the effects of prognostic factors on the natural history of breast cancer.…”

Section: Patient Populationmentioning

confidence: 99%

See 1 more Smart Citation

Prognostic factors affecting the natural history of node-negative breast cancer

Trudeau

Pritchard

Chapman

et al. 2005

Breast Cancer Res Treat

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Patient Populationmentioning

confidence: 99%

Prognostic factors affecting the natural history of node-negative breast cancer

Trudeau

Pritchard

Chapman

et al. 2005

Breast Cancer Res Treat

Self Cite

View full text Add to dashboard Cite

show abstract

“…Treatment for Breast Cancer-Breast-conserving surgery (BCS) was defined as receiving segmental mastectomy, lumpectomy, quadrantectomy, tylectomy, wedge resection, nipple resection, excisional biopsy, or partial mastectomy unspecified (SEER surgery codes [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29]. 23 Mastectomy was defined as subcutaneous, total (simple), modified radical, radical, or extended radical mastectomy (codes 30-70).…”

Section: Seer Regions) 23mentioning

confidence: 99%

Competing Causes of Death for Women With Breast Cancer and Change Over Time From 1975 to 2003

Fox²,

Lai³

2008

American Journal of Clinical Oncology

View full text Add to dashboard Cite

This study was to determine whether the proportion of death due to breast cancer changed over time in different cohorts of women diagnosed with breast cancer. We identified 316,149 women with breast cancer at age 20 or older during 1975-2003 from the Surveillance, Epidemiology, and End Results 9 tumor registries in the United States. Logistic regression models were used to assess the effects of time period on the likelihood of dying because of breast cancer as underlying cause of death, adjusting for other factors. Overall, underlying cause of death was 52.8% due to breast cancer, 17.8% due to heart disease, and 4.9% due to stroke. Percentage of death due to breast cancer did not change significantly from 1975 to 2003 in those who died <12 months after diagnosis, but decreased significantly in women who died between 1 and 15 years. Risk of death due to breast cancer in women diagnosed during 1995-1998 was significantly lower than those in [1975][1976][1977][1978][1979] (odds ratio = 0.79, 95% confidence interval = 0.70 -0.89), after adjusting for age, race, ethnicity, and tumor stage. Percentage of death due to breast cancer decreased significantly with age from 87.5% in women <40% to 30.7% in those 80 or older, which was not significantly affected by year of diagnosis. Proportion of death due to breast cancer increased with advanced tumor stage and was similar in various racial/ethnic groups of population. The findings demonstrated that the impact of breast cancer on overall death was reduced after 1 year of diagnosis, but suggested the need for continued cancer surveillance.Keywords breast cancer; cause of death; women; SEER; tumor registry; temporal trend Breast cancer is the most commonly diagnosed cancer and the leading cause of cancer death in women. 1-4 According to the American Cancer Society data, it was estimated that 212,920 women will be diagnosed with and 40,970 women will die of breast cancer in 2006. 3 During the past decade, mortality for patients with breast cancer decreased significantly, 1 largely because of early detection or screening for breast cancer and advances in medical care and treatments. 5-17 As a result, many patients with breast cancer can live much longer than ever before, and many of these women will die of causes other than breast cancer when they are getting older. However, there is little information on how the main underlying causes of death changed over time during the past several decades for women with breast cancer, although NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript several studies have examined competing causes of death for women with breast cancer and found that other causes of death increased with age. 18-22 Schairer et al found that the probability of death from breast cancer relative to the probability of death from other causes declined with age. 22 However, it is unknown if the proportion of death from breast cancer relative to other causes changed over time in different cohorts of women diagnosed with breast cancer from 19...

show abstract

“…Online was developed [3] , to 61 years in the US in 2011 [4] . Recent studies have shown that more than fifty percent of women may now be expected to die from a cause other than breast cancer, with an increasing proportion of non-breast cancers occurring at older ages [4][5][6] . Adjuvant!…”

Section: Introductionmentioning

confidence: 99%

Competing risks of death in younger and older postmenopausal breast cancer patients

Chapman

Pritchard

Goss

et al. 2014

WJCO

View full text Add to dashboard Cite

AIM:To show a new paradigm of simultaneously testing whether breast cancer therapies impact other causes of death. METHODS:MA.14 allocated 667 postmenopausal women to 5 years of tamoxifen 20 mg/daily ± 2 years of octreotide 90 mg, given by depot intramuscular injections monthly. Event-free survival was the primary endpoint of MA.14; at median 7.9 years, the tamoxifen+octreotide and tamoxifen arms had similar event-free survival (P = 0.62). Overall survival was a secondary endpoint, and the two trial arms also had similar overall survival (P = 0.86). We used the median 9.8 years follow-up to examine by intention-to-treat, the multivariate time-to-breast cancer-specific (BrCa) and other cause (OC) mortality with log-normal survival analysis adjusted by treatment and stratification factors. We tested whether baseline factors including Insulin-like growth factor 1 (IGF1), IGF binding protein-3, C-peptide, body mass index, and 25-OH vitamin D were associated with (1) all cause mortality, and if so; and (2) cause-specific mortality. We also fit step-wise forward cause-specific adjusted models. RESULTS:The analyses were performed on 329 patients allocated tamoxifen and 329 allocated tamoxifen+octreotide. The median age of MA.14 patients was 60.1 years: 447 (82%) < 70 years and 120 (18%) ≥ 70 years. There were 170 deaths: 106 (62.3%) BrCa; 55 (32.4%) OC, of which 24 were other malignancies, 31 other causes of death; 9 (5.3%) patients with unknown cause of death were excluded from competing risk assessments. BrCa and OC deaths were not significantly different by treatment arm (P = 0.40): tamoxifen patients experienced 50 BrCa and 32 OC deaths, while tamoxifen + octreotide patients experienced 56 BrCa and 23 OC deaths. Proportionately more deaths (P = 0.004) were from BrCa for patients RETROSPECTIVE STUDYCompeting risks of death in younger and older postmenopausal breast cancer patients < 70 years, where 70% of deaths were due to BrCa, compared to 54% for those ≥ 70 years of age. The proportion of deaths from OC increased with increasing body mass index (BMI) (P = 0.02). Higher pathologic T and N were associated with more BrCa deaths (P < 0.0001 and 0.002, respectively). The cumulative hazard plot for BrCa and OC mortality indicated the concurrent accrual of both types of death throughout followup, that is the existence of competing risks of mortality. MA.14 therapy did not impact mortality (P = 0.77). Three baseline patient and tumor characteristics were differentially associated with cause of death: older patients experienced more OC (P = 0.01) mortality; patients with T1 tumors and hormone receptor positive tumors had less BrCa mortality (respectively, P = 0.01, P = 0.06). Additionally, step-wise cause-specific models indicated that patients with node negative disease experienced less BrCa mortality (P = 0.002); there was weak evidence that, lower C-peptide (P = 0.08) was associated with less BrCa mortality, while higher BMI (P = 0.01) was associated with worse OC mortality. CONCLUSION:We demonstrate here a ne...

show abstract

Competing causes of death for primary breast cancer

Abstract: With increased lifespan, there will be more breast cancer cases in women older than 65 years; we have shown that women in this group have more non-breast cancer deaths. It becomes important, then, to delineate differential effects of prognostic factors on competing causes of death.

Cited by 37 publications

References 11 publications

Prognostic factors affecting the natural history of node-negative breast cancer

Prognostic factors affecting the natural history of node-negative breast cancer

Competing Causes of Death for Women With Breast Cancer and Change Over Time From 1975 to 2003

Competing risks of death in younger and older postmenopausal breast cancer patients

Contact Info

Product

Resources

About