Evidence map›Paper›PMID 38976577›Full record

ArticleBJS open2024

Survival outcomes after breast cancer surgery among older women with early invasive breast cancer in England: population-based cohort study.

Katie Miller, Melissa Ruth Gannon, Jibby Medina, Karen Clements, David Dodwell, Kieran Horgan, Min Hae Park, David Alan Cromwell

Abstract read
In one paragraph

Article in BJS open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Katie MillerClinical Effectiveness Unit, The Royal College of Surgeons of England, London, UK.ORCID 0000-0001-8079-9980
Melissa Ruth GannonClinical Effectiveness Unit, The Royal College of Surgeons of England, London, UK.
Jibby MedinaClinical Effectiveness Unit, The Royal College of Surgeons of England, London, UK.
Karen ClementsThe National Disease Registration Service, NHS England, Birmingham, UK.
David DodwellNuffield Department of Population Health, University of Oxford, Oxford, UK.
Kieran HorganDepartment of Breast Surgery, St James's University Hospital, Leeds, UK.
Min Hae ParkClinical Effectiveness Unit, The Royal College of Surgeons of England, London, UK.
David Alan CromwellClinical Effectiveness Unit, The Royal College of Surgeons of England, London, UK.

Funding

Healthcare Quality Improvement PartnershipNational Audit of Breast Cancer in Older PatientsNational Clinical Audit and Patient OutcomesNHS EnglandWelsh Government
6 · The paper itself

Abstract

backgroundThis study assessed the influence of age, co-morbidity and frailty on 5-year survival outcomes after breast conservation surgery (BCS) with radiotherapy (RT) versus mastectomy (with or without RT) in women with early invasive breast cancer.

methodsWomen aged over 50 years with early invasive breast cancer diagnosed in England (2014-2019) who had breast surgery were identified from Cancer Registry data. Survival estimates were calculated from a flexible parametric survival model. A competing risk approach was used for breast cancer-specific survival (BCSS). Standardized survival probabilities and cumulative incidence functions for breast cancer death were calculated for each treatment by age.

resultsAmong 101 654 women, 72.2% received BCS + RT and 27.8% received mastectomy. Age, co-morbidity and frailty were associated with overall survival (OS), but only age and co-morbidity were associated with BCSS. Survival probabilities for OS were greater for BCS + RT (90.3%) versus mastectomy (87.0%), and the difference between treatments varied by age (50 years: 1.9% versus 80 years: 6.5%). Cumulative incidence functions for breast cancer death were higher after mastectomy (5.1%) versus BCS + RT (3.9%), but there was little change in the difference by age (50 years: 0.9% versus 80 years: 1.2%). The results highlight the change in baseline mortality risk by age for OS compared to the stable baseline for BCSS.

conclusionFor OS, the difference in survival probabilities for BCS + RT and mastectomy increased slightly with age. The difference in cumulative incidence functions for breast cancer death by surgery type was small regardless of age. Evidence on real-world survival outcomes among older populations with breast cancer is informative for treatment decision-making.

Indexed as

Breast NeoplasmsMastectomyAgedAged, 80 and overAge FactorsCohort StudiesComorbidityEnglandFemaleFrailtyHumansMastectomy, SegmentalMiddle AgedRegistries

Identifiers

PMID38976577
PMCPMC11229699

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.