Primary breast cancer therapy in six regions of Germany

Engel, Jutta; Nagel, Gabriële; Breuer, Eun-Kyoung; Meisner, C; Albert, U.-S.; K, Strelocke; Sauer, H.; Katenkamp, D.; Mittermayer, Ch.; Heidemann, E.; Schulz, K.-D.; Kunath, H; Lorenz, W.; Hölzel, Dieter

doi:10.1016/s0959-8049(01)00407-5

Cited by 49 publications

(33 citation statements)

References 37 publications

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“…Comparisons were drawn with a historic cohort on primary breast cancer therapy in six regions of Germany, which was published in 2002 and comprised a sample of N ¼ 8661 (Engel et al, 2002). The proportion of patients aged X70 years was 2425 out of 8661 (27.9%, C.I.…”

Section: Resultsmentioning

confidence: 99%

“…The most simple and often found method (Engel et al, 2002) for analysing differences is collapsing the individual data points into QoL scores and comparing their means. In our case, patientreported global QoL was 66.7 (50.0 -77.1) points (median and interquartile range), mean 61.5 and standard deviation 23.2, significantly lower than doctors' judgement of patients ' global QoL,3), respectively, mean 71.0 and s.d.…”

Section: Very Goodmentioning

confidence: 99%

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Implementing a system of quality-of-life diagnosis and therapy for breast cancer patients: results of an exploratory trial as a prerequisite for a subsequent RCT

Klinkhammer‐Schalke¹,

Koller

Ehret³

et al. 2008

Br J Cancer

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A system for quality-of-life diagnosis and therapy (QoL system) was implemented for breast cancer patients. The system fulfilled the criteria for complex interventions (Medical Research Council). Following theory and modeling, this study contains the exploratory trial as a next step before the randomised clinical trial (RCT) answering three questions: (1) Are there differences between implementation sample and general population? (2) Which amount and type of disagreement exist between patient and coordinating practitioners (CPs) in assessed global QoL? (3) Are there empirical reasons for a cutoff of 50 points discriminating between healthy and diseased QoL? Implementation was successful: 74% of CPs worked along the care pathway. However, CPs showed preferences for selecting patients with lower age and UICC prognostic staging. Patients and CPs disagreed considerably in values of global QoL, despite education in QoL assessment by outreach visits, opinion leaders and CME: Zero values of QoL were only expressed by patients. Finally, the cutoff of 50 points was supported by the relationship between QoL in single items and global QoL: no patients with values above 50 dropped global QoL below 50, but values below 50 and especially at 0 points in single items, induced a dramatic fall of global QoL down to below 50. The exploratory trial was important for defining the complex intervention in the definitive RCT: control for age and prognostic stage grading, support for a QoL unit combining patient's and CP's assessment of QoL and support for the 50-point cutoff criterion between healthy and diseased QoL.

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Section: Resultsmentioning

confidence: 99%

Section: Very Goodmentioning

confidence: 99%

Implementing a system of quality-of-life diagnosis and therapy for breast cancer patients: results of an exploratory trial as a prerequisite for a subsequent RCT

Klinkhammer‐Schalke¹,

Koller

Ehret³

et al. 2008

Br J Cancer

Self Cite

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“…Prognostically, pure mucinous carcinomas have an excellent prognosis, but the outcome for mixed mucinous carcinomas is similar to NST tumors [15]. …”

Section: Special Subtypes Of Invasive Breast Carcinomamentioning

confidence: 99%

A Brief Overview of the WHO Classification of Breast Tumors, 4th Edition, Focusing on Issues and Updates from the 3rd Edition

2013

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The WHO Classification of Tumors of the Breast, 4th edition, is an update to the 3rd edition that was published in 2003, and covers all neoplastic and preneoplastic lesions of the breast. Changes to the 4th edition include new aspects and changes to the terminology that reflect our present-day knowledge of these lesions. Definitions for histopathological diagnosis are complemented by a description of clinical features, epidemiology, macroscopy, genetics, and prognostic and predictive features. In this review of the WHO classification, we have focused on invasive carcinomas, precursor lesions, and some benign epithelial proliferations.

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“…While limited data regarding treatment compliance with adjuvant endocrine therapy suggest that compliance may be an issue in women with breast cancer [12][13][14], these findings are not from prospective studies in real-life clinical settings. Furthermore, while data are available on the practice of prescribing AIs in Germany [15,16], these do not accurately capture whether the medication was actually taken correctly.…”

Section: Introductionmentioning

confidence: 99%

Patient's Anastrozole Compliance to Therapy (PACT) Program: Baseline Data and Patient Characteristics from a Population-Based, Randomized Study Evaluating Compliance to Aromatase Inhibitor Therapy in Postmenopausal Women with Hormone-Sensitive Early Breast Cancer

Harbeck

Blettner²,

Hadji

et al. 2013

Breast Care

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Background: The Patient's Anastrozole Compliance to Therapy (PACT) program is a large randomized study designed to assess whether the provision of educational materials (EM) could improve compliance with aromatase inhibitor therapy in postmenopausal women with early, hormone receptor-positive breast cancer. Patients and Methods: The PACT study presented a large, homogeneous dataset. The baseline analysis included patient demographics and initial treatments and patient perceptions about treatment and quality of life. Results: Overall, 4,923 patients were enrolled at 109 German breast cancer centers/clinics in cooperation with 1,361 office-based gynecologists/oncologists. 4,844 women were randomized 1:1 to standard therapy (n = 2,402) or standard therapy plus EM (n = 2,442). Prior breast-conserving surgery and mastectomy had been received by 76% and 24% of the patients, respectively. Radiotherapy was scheduled for 85% of the patients, adjuvant chemotherapy for 38%. Reflecting the postmenopausal, hormone-sensitive nature of this population, only 285 patients (7%) had received neoadjuvant chemotherapy. Conclusions: A comparison with epidemiological data from the West German Breast Center suggests that the patients in the PACT study are representative of a general postmenopausal early breast cancer population and that the findings may be applicable to ‘real-world' Germany and beyond. Compliance data from PACT are eagerly anticipated.

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Primary breast cancer therapy in six regions of Germany

Cited by 49 publications

References 37 publications

Implementing a system of quality-of-life diagnosis and therapy for breast cancer patients: results of an exploratory trial as a prerequisite for a subsequent RCT

Implementing a system of quality-of-life diagnosis and therapy for breast cancer patients: results of an exploratory trial as a prerequisite for a subsequent RCT

A Brief Overview of the WHO Classification of Breast Tumors, 4th Edition, Focusing on Issues and Updates from the 3rd Edition

Patient's Anastrozole Compliance to Therapy (PACT) Program: Baseline Data and Patient Characteristics from a Population-Based, Randomized Study Evaluating Compliance to Aromatase Inhibitor Therapy in Postmenopausal Women with Hormone-Sensitive Early Breast Cancer

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