scholarly journals Quantitative measures of estrogen receptor expression in relation to breast cancer-specific mortality risk among white women and black women

2013 ◽  
Vol 15 (5) ◽  
Author(s):  
Huiyan Ma ◽  
Yani Lu ◽  
Polly A Marchbanks ◽  
Suzanne G Folger ◽  
Brian L Strom ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Estrogen Receptor ◽  
Black Women ◽  
Mortality Risk ◽  
White Women ◽  
Receptor Expression ◽  
Estrogen Receptor Expression ◽  
Breast Cancer Specific Mortality ◽  
Specific Mortality ◽  
Cancer Specific Mortality

scholarly journals Public health insurance and cancer-specific mortality risk among patients with breast cancer: a prospective cohort study in China

2020 ◽  
Author(s):  
yuxin Xie ◽  
Unnur A. Valdimarsdóttir ◽  
Chengshi Wang ◽  
XiaoRong Zhong ◽  
Qiheng Gou ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Health Insurance ◽  
Mortality Risk ◽  
Cancer Prognosis ◽  
Total Charge ◽  
Reimbursement Rate ◽  
Insurance Scheme ◽  
Breast Cancer Specific Mortality ◽  
Specific Mortality ◽  
Cancer Specific Mortality

Abstract Background Little is known about how health insurance policies, particularly in developing countries, may influence breast cancer prognosis. We aimed to examine the association between individual health insurance plans and breast cancer-specific mortality among patients in China.Methods We included 7,436 women diagnosed with invasive breast cancer between January 1 st , 2009, and December 31 st , 2016, at West China Hospital, Sichuan University. The health insurance plan of each patient was classified as either urban or rural schemes and was also categorized as reimbursement rate (i.e., the covered/ total charge) below or above the median. Breast cancer-specific mortality was the primary outcome. Using Cox proportional hazards models, we calculated hazard ratios (HRs) for cancer-specific mortality, contrasting rates among patients with a rural insurance scheme or low reimbursement rate to that of those with an urban insurance scheme or high reimbursement rate, respectively.Results During the median follow-up of 3.1 years, we identified 326 deaths due to breast cancer. Compared with patients covered by urban insurance schemes, patients covered by rural insurance schemes had a 29% increased cancer-specific mortality (95% CI 0% to 65%, P=0.046) after adjusting for demographics, tumor characteristics, and treatment modes. Reimbursement rate below the median was associated with a 42% increased rate of cancer-specific mortality (95% CI 11% to 82%). Every 10% increase in the reimbursement rate is associated with a 7% (95% CI, 2% to 12%) reduction in cancer-specific mortality risk, particularly in patients covered by rural insurance schemes (26%, 95% CI 9% to 39%).Conclusions Our findings suggest that under-insured patients with breast cancer in China face increased breast cancer-specific mortality, which may provide fresh insights into the role of reimbursement rate in cancer health disparities.

scholarly journals Mortality After Invasive Second Breast Cancers Following Prior Radiotherapy for DCIS

2019 ◽  
Vol 17 (11) ◽  
pp. 1367-1371 ◽  
Author(s):  
Puyao C. Li ◽  
Zilu Zhang ◽  
Angel M. Cronin ◽  
Rinaa S. Punglia
Keyword(s):  
Breast Cancer ◽  
Ductal Carcinoma ◽  
Interaction Analysis ◽  
Receptor Expression ◽  
Breast Cancer Specific Mortality ◽  
Increased Risk ◽  
Significant Difference ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
The Impact

Background: Women with a history of ductal carcinoma in situ (DCIS) are at increased risk for developing a second breast cancer (SBC). A prior meta-analysis of randomized studies of radiotherapy (RT) for DCIS has shown a trend toward increased breast cancer–specific mortality after SBC, but it did not have the power needed to detect a significant difference, due to a limited number of recurrences. This study sought to evaluate the impact of RT for DCIS on mortality after SBC in a larger cohort. Patients and Methods: Using the SEER database, 3,407 patients were identified who received breast-conserving therapy with or without RT for primary DCIS in 2000 through 2013 and subsequently developed a stage I–III invasive SBC within the same time period. Fine-Gray competing risk models were used to study the association between receipt of RT and mortality after SBC. Results: Prior RT was found to be associated with higher rates of breast cancer–specific mortality (hazard ratio [HR], 1.70; 95% CI, 1.18–2.45; P=.005), even after controlling for cancer stage. Interaction analysis suggested that this risk trended higher in patients with ipsilateral versus contralateral SBC (HR, 2.07 vs 1.26; P=.16). Furthermore, compared with patients who developed contralateral SBC, those with ipsilateral SBC were younger (P<.001) and more often lacked estrogen receptor expression (P<.001). Conclusions: Patients who previously received RT for DCIS had higher mortality after developing an invasive SBC than those who did not receive RT. This finding may have implications for initial treatment decisions in the management of DCIS.

scholarly journals Associated Factors and Survival Outcomes for Breast Conserving Surgery versus Mastectomy among New Zealand Women with Early-Stage Breast Cancer

2021 ◽  
Vol 18 (5) ◽  
pp. 2738
Author(s):  
Mohammad Shoaib Abrahimi ◽  
Mark Elwood ◽  
Ross Lawrenson ◽  
Ian Campbell ◽  
Sandar Tin Tin
Keyword(s):  
Breast Cancer ◽  
Regression Analysis ◽  
New Zealand ◽  
Early Stage ◽  
Breast Conserving Surgery ◽  
Early Stage Breast Cancer ◽  
Clinical Factors ◽  
Breast Cancer Specific Mortality ◽  
Specific Mortality ◽  
Cancer Specific Mortality

This study aimed to investigate type of loco-regional treatment received, associated treatment factors and mortality outcomes in New Zealand women with early-stage breast cancer who were eligible for breast conserving surgery (BCS). This is a retrospective analysis of prospectively collected data from the Auckland and Waikato Breast Cancer Registers and involves 6972 women who were diagnosed with early-stage primary breast cancer (I-IIIa) between 1 January 2000 and 31 July 2015, were eligible for BCS and had received one of four loco-regional treatments: breast conserving surgery (BCS), BCS followed by radiotherapy (BCS + RT), mastectomy (MTX) or MTX followed by radiotherapy (MTX + RT), as their primary cancer treatment. About 66.1% of women received BCS + RT, 8.4% received BCS only, 21.6% received MTX alone and 3.9% received MTX + RT. Logistic regression analysis was used to identify demographic and clinical factors associated with the receipt of the BCS + RT (standard treatment). Differences in the uptake of BCS + RT were present across patient demographic and clinical factors. BCS + RT was less likely amongst patients who were older (75+ years old), were of Asian ethnicity, resided in impoverished areas or areas within the Auckland region and were treated in a public healthcare facility. Additionally, BCS + RT was less likely among patients diagnosed symptomatically, diagnosed during 2000–2004, had an unknown tumour grade, negative/unknown oestrogen and progesterone receptor status or tumour sizes ≥ 20 mm, ≤50 mm and had nodal involvement. Competing risk regression analysis was undertaken to estimate the breast cancer-specific mortality associated with each of the four loco-regional treatments received. Over a median follow-up of 8.8 years, women who received MTX alone had a higher risk of breast cancer-specific mortality (adjusted hazard ratio: 1.38, 95% confidence interval (CI): 1.05–1.82) compared to women who received BCS + RT. MTX + RT and BCS alone did not have any statistically different risk of mortality when compared to BCS + RT. Further inquiry is needed as to any advantages BCS + RT may have over MTX alternatives.

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