Recurrence and Mortality Rates Among Receivers and Decliners of Conventional Adjuvant Breast Cancer Treatments

Abstract

Objectives: This paper compared Recurrence and Morality rates among women with breast cancer who received all recommended treatment (Receivers) and who did not (Decliners). Methods: 427 women were recruited through integrative oncology clinics and the Cancer Surveillance System (CSS) registry in Western Washington State. Secondary data analysis were conducted using descriptive statistics, t-tests, X2 tests, and R. Self-reported data included household income and comorbidity; medical records included dates of diagnosis, recurrence and last visit with medical oncologist; and CSS registry data included demographic, disease characteristics, and records on recommended treatments and receiving/declining them, and date of death. Results: 9% of Receivers and 2% of Decliners experienced a Disease Free Survival (DFS) limiting event commonly a recurrence, while 3% of Receivers and 2% of Decliners died. After controlling for stage at diagnosis and cohort, no difference was found on the Adjusted Hazard ratio of recurrence or mortality between Receivers and Decliners. Adjusted Hazard ratio of Decliners relative to Receivers was 0.29 (95% CI; 0.04 – 2.22, p = 0.22) for DFS and 0.50 (95% CI: 0.04, 6.49, p = 0.59) for mortality. Conclusions: Better clinical predictors among Decliners may be related to no rate difference in recurrence and mortality between Decliners than Receivers.