Evidence map›Paper›PMID 42365454›Full record

ArticleThe breast journal2026

Real-World Practice Patterns in Diagnosis and First-Line Treatment in Metastatic Breast Cancer.

Poorni M Manohar, Veena Shankaran, Nancy E Davidson, Natasha Hunter, William R Gwin, Rachel L Yung, Jennifer M Specht, Catherine Federenko, Sun Qin, Qian Vicky Wu and 3 more

Abstract read
In one paragraph

Article in The breast journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

13 authors.

Poorni M ManoharDepartment of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA, rush.edu.ORCID https://orcid.org/0000-0003-1215-3787
Veena ShankaranDepartment of Internal Medicine, University of Washington/Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
Nancy E DavidsonDepartment of Internal Medicine, University of Washington/Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
Natasha HunterDepartment of Internal Medicine, University of Washington/Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
William R GwinDepartment of Internal Medicine, University of Washington/Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
Rachel L YungDepartment of Internal Medicine, University of Washington/Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
Jennifer M SpechtDepartment of Internal Medicine, University of Washington/Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.ORCID https://orcid.org/0000-0003-1484-2113
Catherine FederenkoDepartment of Internal Medicine, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA, fredhutch.org.
Sun QinDepartment of Internal Medicine, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA, fredhutch.org.
Qian Vicky WuDepartment of Internal Medicine, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA, fredhutch.org.
Jenna M VoustinasDepartment of Internal Medicine, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA, fredhutch.org.
Josh A RothPfizer Inc., New York, New York, USA, pfizer.com.ORCID https://orcid.org/0000-0001-6621-8342
Hannah M LindenDepartment of Internal Medicine, University of Washington/Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.

Funding

Translational Bioimaging Core Shared ResourceP30CA015704 · NCI · FRED HUTCHINSON CANCER RESEARCH CENTER · PI Eric Collisson · 1985 to 2026
$296.4M
TRAINING IN CANCER BIOLOGY &TRANSPLANTATIONT32CA009515 · NCI · UNIVERSITY OF WASHINGTON · PI NANCY ELLEN DAVIDSON, Effie W Petersdorf · 1985 to 2026
$16.2M
American Society of Clinical OncologyNCI NIH HHS P30 CA015704NCI NIH HHS T32 CA009515NIH HHS T32CA009515Pfizer
6 · The paper itself

Abstract

introDivergence from national guidelines and variations in practice patterns impact care and outcomes in patients with metastatic breast cancer (MBC). We sought to assess the quality of care in the diagnosis and treatment of real-world patients with MBC in Washington State.

methodsData were retrospectively analyzed using a linked cancer registry and insurance claims platform for patients with recurrent or de novo MBC diagnosed between 2008 and 2019.

resultsWe identified 1101 patients with MBC (median age: 66), 715 recurrent and 386 de novo. Most patients were White (89%), all were insured (Commercial [47%], Medicaid [4%], Medicare [35%], or multiple [13%]), and 15% lived in areas of high deprivation (Area Deprivation Index [ADI]: 8-10). Of the patients with recurrent MBC, less than half received a biopsy (49.5%) or biomarker reassessment (48.7%) to confirm the diagnosis of MBC. Patients treated at high- and medium-volume centers had higher rates of biopsy than low-volume clinics (51.9%, 54.3%, and 40.7%, respectively, p = 0.03). ET alone was more common in patients who did not undergo biopsy (62.3% vs. 37.7%, p < 0.001) or biomarker reassessment (62.7% vs. 37.3%, p < 0.001). Among the 677 patients with estrogen receptor (ER)+/HER2- MBC (de novo and recurrent), most received ET alone (69%), followed by CT (22%) and CDKi + ET (9%). Importantly, 40% of patients were treated before CDK4/6i approval. Most patients who received CDKi + ET were < 65 years old (65.2%, p < 0.02). Patients with commercial insurance were more likely to receive CDKi + ET compared to those with Medicare/Medicaid. (60.9% vs. 26.1%, p = 0.10).

conclusionOur findings highlight key gaps in MBC management and serve as a launch point for patient-centered and quality-promoting initiatives.

Indexed as

Breast NeoplasmsPractice Patterns, Physicians'AdultAgedAged, 80 and overBiopsyFemaleHumansMiddle AgedNeoplasm MetastasisRegistriesRetrospective StudiesWashingtonbiopsyCDK4/6 inhibitorsmetastatic breast cancerquality of caretreatment patterns

Identifiers

PMID42365454
PMCPMC13310376

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.