ArticleJournal of the American College of Surgeons2011
Age, comorbidity, and breast cancer severity: impact on receipt of definitive local therapy and rate of recurrence among older women with early-stage breast cancer.
Article in Journal of the American College of Surgeons, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed, 34 citations in OpenAlex.
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- Treatment and survival outcomes in older women with primary breast cancer: A retrospective propensity score-matched analysis.Breast (Edinburgh, Scotland) · 2022Article
- Surgical options of the breast and clinical outcomes of breast cancer patients after neoadjuvant chemotherapy: A single-center retrospective study.Frontiers in oncology · 2022Article
- Risk of cancer death by comorbidity severity and use of adjuvant chemotherapy among women with locoregional breast cancer.Journal of geriatric oncology · 2018Article
- Disparities in the Initial Local Treatment of Older Women with Early-Stage Breast Cancer: A Population-Based Study.Journal of women's health (2002) · 2017Observational
- Treatment patterns for ductal carcinoma in situ from 2000-2010 across six integrated health plans.SpringerPlus · 2015Article
- Validating billing/encounter codes as indicators of lung, colorectal, breast, and prostate cancer recurrence using 2 large contemporary cohorts.Medical care · 2014Article
- Colon cancer treatment: are there racial disparities in an equal-access healthcare system?Diseases of the colon and rectum · 2014Article
- The influence of diabetes severity on receipt of guideline-concordant treatment for breast cancer.Breast cancer research and treatment · 2014Article
- Comorbidity burden and guideline-concordant care for breast cancer.Journal of the American Geriatrics Society · 2014Article
- Comparison of the Freiburg and Charlson comorbidity indices in predicting overall survival in elderly patients with newly diagnosed multiple myeloma.BioMed research international · 2014Article
- Impact of undetected comorbidity on treatment and outcomes of breast cancer.International journal of breast cancer · 2014Article
- Long-term surveillance mammography and mortality in older women with a history of early stage invasive breast cancer.Breast cancer research and treatment · 2013Article
- Article
- Factors associated with the frequency of initial total mastectomy: results of a multi-institutional study.Journal of the American College of Surgeons · 2013Article
- Cancer research network: using integrated healthcare delivery systems as platforms for cancer survivorship research.Journal of cancer survivorship : research and practice · 2013Review
- Patient, hospital, and neighborhood factors associated with treatment of early-stage breast cancer among Asian American women in California.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2012Article
- Cancer outcomes in low-income elders: is there an advantage to being on Medicaid?Medicare & medicaid research review · 2012Article
- Time from Screening Mammography to Biopsy and from Biopsy to Breast Cancer Treatment among Black and White, Women Medicare Beneficiaries Not Participating in a Health Maintenance Organization.Women's health issues : official publication of the Jacobs Institute of Women's HealthArticle
- Comparison of the Initial Loco-Regional Treatment Received for Early-Stage Breast Cancer between Elderly Women in Appalachia and a United States - Based Population: Good and Bad News.Global journal of breast cancer researchArticle
Corrections and comments
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Authors and funding
10 authors at 6 institutions in 1 country.
Funding
Abstract
backgroundThe definitive local therapy options for early-stage breast cancer are mastectomy and breast-conserving surgery followed by radiation therapy. Older women and those with comorbidities frequently receive breast-conserving surgery alone. The interaction of age and comorbidity with breast cancer severity and their impact on receipt of definitive therapy have not been well-studied. STUDY
designIn a cohort of 1,837 women aged 65 years and older receiving treatment for early-stage breast cancer in 6 integrated health care delivery systems in 1990-1994 and followed for 10 years, we examined predictors of receiving nondefinitive local therapy and assessed the impact on breast cancer recurrence within levels of severity, defined as level of risk for recurrence.
resultsAge and comorbidity were associated with receipt of nondefinitive therapy. Compared with those at low risk, women at the highest risk were less likely to receive nondefinitive therapy (odds ratio = 0.32; 95% CI, 0.22-0.47), and women at moderate risk were about half as likely (odds ratio = 0.54; 95% CI, 0.35-0.84). Nondefinitive local therapy was associated with higher rates of recurrence among women at moderate (hazard ratio = 5.1; 95% CI, 1.9-13.5) and low risk (hazard ratio = 3.2; 95% CI, 1.1-8.9). The association among women at high risk was weak (hazard ratio = 1.3; 95% CI, 0.75-2.1).
conclusionsAmong these older women with early-stage breast cancer, decisions about therapy partially balanced breast cancer severity against age and comorbidity. However, even among women at low risk, omitting definitive local therapy was associated with increased recurrence.
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