Receipt of guideline-concordant care and survival among young adult women with non-metastatic breast cancer.

IF 3 3区 医学 Q2 ONCOLOGY
Manami Bhattacharya, Benmei Liu, Allison W Kurian, Jennifer Stevens, Lindsey Enewold, Dolly C Penn
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引用次数: 0

Abstract

Purpose: Adolescent and young adults (AYA) with breast cancer, compared to older adults, are diagnosed with more aggressive cancers, at more advanced stages and may undergo more aggressive treatment but have worse survival. Despite this, no research has studied the effects of the receipt of National Comprehensive Cancer Network (NCCN) defined guideline-concordant care (GCC) for breast cancer on AYA survival. We examined the association of GCC with survival among young adult (20-39 years old) breast cancer survivors.

Methods: We used the Patterns of Care Study; a stratified random sample of 952 young adult women diagnosed with Stage I-III breast cancer in 2013. NCCN guidelines were used to categorize treatment as GCC or non-GCC. We used Kaplan-Meier curves, log-rank tests, and Cox-proportional hazards models to evaluate the effect of GCC on breast cancer-specific survival, stratifying by triple-negative breast cancer (TNBC) and non-TNBC, and adjusting for sociodemographic and clinical factors.

Results: All univariate analyses showed that non-GCC was associated with worse survival than GCC. The association was statistically significant for non-TNBC (Hazard ratio: 3.45, CI 1.64-7.29) and TNBC (Hazard ratio: 3.70, CI 1.02-13.43) in multivariable Cox models adjusted for sociodemographic variables and for non-TNBC (Hazard ratio: 3.13, CI 1.13-8.72) when the model was adjusted for sociodemographic and clinical variables.

Conclusion: Among young adult women with non-metastatic breast cancer, while receipt of NCCN GCC is univariately associated with better survival for both TNBC and non-TNBC, the effect of sociodemographic and clinical factors on the association differs by TNBC status. Further investigation with larger TNBC samples is needed.

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来源期刊
CiteScore
6.80
自引率
2.60%
发文量
342
审稿时长
1 months
期刊介绍: Breast Cancer Research and Treatment provides the surgeon, radiotherapist, medical oncologist, endocrinologist, epidemiologist, immunologist or cell biologist investigating problems in breast cancer a single forum for communication. The journal creates a "market place" for breast cancer topics which cuts across all the usual lines of disciplines, providing a site for presenting pertinent investigations, and for discussing critical questions relevant to the entire field. It seeks to develop a new focus and new perspectives for all those concerned with breast cancer.
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