Clinical breast cancer最新文献

{"title":"Does Sentinel Lymph Node Biopsy Influence Subsequent Management Decisions in Women With Breast Cancer ≥ 70 Years Old?","authors":"","doi":"10.1016/j.clbc.2024.05.002","DOIUrl":"10.1016/j.clbc.2024.05.002","url":null,"abstract":"<div><h3>Background</h3><p>There have been ongoing attempts to de-escalate surgical intervention in older breast cancer patients in recent years. However, there remains ongoing hesitancy amongst surgeons to de-implement axillary staging in this cohort. The supporting argument for performing a sentinel lymph node biopsy (SLNB) is that it may guide subsequent management.</p></div><div><h3>Methods</h3><p>A retrospective review was performed of 356 SLNBs, in 342 women ≥ 70 years of age with invasive breast cancer, between 2014 and 2022 in a single institution. Data were collected on patient and tumor characteristics and subsequent management for all patients and for patients with ER+/HER2-, early-stage disease.</p></div><div><h3>Results</h3><p>Positive SLNB significantly increased likelihood of receiving adjuvant chemotherapy (CTh) in patients aged 70-75 in all clinical subtypes (OR 4.0, 95% CI, 1.6-10; <em>P</em> = .0035). Positive SLNB did not significantly increase likelihood of receiving adjuvant CTh in patients aged 75-80, however, an Oncotype Dx score of ≥ 26 did (OR 34.50, 95% CI, 3.00-455.2; <em>P</em> = .0103). Positive SLNB was significantly associated with receiving adjuvant radiotherapy (RTh) in all patients aged 70-75 (OR 4.5, 95% CI, 2.0-11; <em>P</em> = .0004) and 75-80 (OR 9.7, 95% CI, 2.7-46; <em>P</em> = .0015). In patients aged ≥ 80 years, positive SLNB did not have a significant influence on subsequent treatments.</p></div><div><h3>Conclusion</h3><p>In this study, SLNB did not significantly influence subsequent management decisions in patients over 80 and should rarely be performed in this cohort. However, SLNB still had a role in patients aged 70-80 and should be used selectively in this cohort.</p></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"24 6","pages":"Pages 510-518.e4"},"PeriodicalIF":2.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1526820924001150/pdfft?md5=8fb6befa74331196c3e27ba7982a0d24&pid=1-s2.0-S1526820924001150-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141053802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression and Clinical Significance of NUDCD1, PI3K/AKT/mTOR Signaling Pathway-Related Molecules and Immune Infiltration in Breast Cancer","authors":"","doi":"10.1016/j.clbc.2024.02.022","DOIUrl":"10.1016/j.clbc.2024.02.022","url":null,"abstract":"<div><h3>Background</h3><p>NUDCD1 (NudC Domain Containing 1) performs an essential function in biological processes such as cell progression, migration, cell cycle, and intracellular material transport. Many solid tumors express it highly, which is a prospective biomarker and therapeutic approach. However, the expression and clinical importance of NUDCD1 across breast cancer is unclear.</p></div><div><h3>Methods</h3><p>The expressions of NUDCD1 in breast cancers and normal breast tissues were studied utilizing the TIMER database and immunohistochemical analysis. Subsequently, we validate the association between the expression of NUDCD1 and clinicopathologic features and prognosis of breast cancer. The immunohistochemical experiments of pathway-related molecules were done on 214 breast cancer tissue microarrays. The investigation of correlation between NUDCD1 expression and tumor immune infiltration was subsequently conducted.</p></div><div><h3>Results</h3><p>Through the utilization of bioinformatics analysis and immunohistochemical experiments, it was determined that NUDCD1 exhibited upregulation within breast cancer. Furthermore, it was discovered that an elevated expression of NUDCD1 may potentially be linked to a worse prognosis in breast cancer. Our study reveals that the PI3K/AKT/mTOR signaling pathway may perform a function in NUDCD1 regulating breast cancer progression via enrichment analysis. Furthermore, the expression of NUDCD1 may be associated with the degree of immunological infiltration.</p></div><div><h3>Conclusion</h3><p>The expression of NUDCD1 was explored to be elevated in breast cancer and was observed to be correlated with a poorer prognosis. p-AKT, PI3K, AKT, mTOR, and p-mTOR expression levels underwent significant elevation in breast cancer. The function of NUDCD1 within breast cancer might be associated with the PI3K/AKT/mTOR signaling pathway.</p></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"24 6","pages":"Pages e429-e451"},"PeriodicalIF":2.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1526820924000600/pdfft?md5=b7dd7b3db06dd0a35b226b4984039dbc&pid=1-s2.0-S1526820924000600-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140057734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Performance in Diagnosis and Characterization of Breast Lesions: Contrast-Enhanced Mammography Versus Breast Magnetic Resonance Imaging","authors":"","doi":"10.1016/j.clbc.2024.04.007","DOIUrl":"10.1016/j.clbc.2024.04.007","url":null,"abstract":"<div><h3>Introduction</h3><p>In contemporary medical practice, magnetic resonance imaging (MRI) is the most sensitive modality for detecting breast cancer. Contrast-enhanced mammography (CEM), a relatively recent technology, represents another contrast-enhanced imaging technique that has the potential to serve as an alternative to breast MRI. Our main goal is to compare the diagnostic accuracy including assessment of sensitivity and specificity of these 2 contrast-enhanced breast imaging methods, CEM and MRI, in the diagnosis and characterization of breast lesions.</p></div><div><h3>Material and methods</h3><p>Our prospective study included patients who were clinically suspected of malignancy and/or had suspicious findings detected by mammography or ultrasound. A total of 116 patients were included, and both CEM and MRI examinations were performed on all patients. All CEM examinations were conducted at our institution, while 56.89% of all MRI examinations were carried out at external centers. While histopathological results were accessible for all malignant lesions, the final diagnosis for 80.5% of benign lesions was established through typical imaging findings and adequate follow-up.</p></div><div><h3>Results</h3><p>This study encompassed a total of 219 lesions, with 125 out of 219 (57.07%) malignant lesions and 94 out of 219 (42.92%) benign lesions. The sensitivity and specificity values were 98.40% and 81.91%, respectively, for CEM, and 100% and 75.33%, respectively, for MRI. Moreover, CEM showcased comparable performance to MRI in evaluating women with dense breasts.</p></div><div><h3>Conclusion</h3><p>CEM and MRI were compared for breast lesion diagnosis, with MRI showing higher sensitivity and CEM higher specificity; however, the differences were not statistically significant.</p></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"24 6","pages":"Pages 481-493"},"PeriodicalIF":2.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140776892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Existing Psychiatric Diagnoses Among Breast Cancer Patients Interact with Outcomes After Autologous and Implant-Based Bilateral Breast Reconstruction: A Propensity Score Matched Analysis","authors":"","doi":"10.1016/j.clbc.2024.03.010","DOIUrl":"10.1016/j.clbc.2024.03.010","url":null,"abstract":"<div><h3>Background</h3><p>Breast reconstruction is an integral postoncologic procedure that has been associated with improved mental health and psychological outcomes. The possible interaction between existing psychiatric diagnoses hospital courses and postoperative complications warrants further exploration.</p></div><div><h3>Methods</h3><p>Bilateral breast reconstruction patients were identified from the 2016 to 2018 Healthcare Cost and Utilization Project-National Inpatient Sample (HCUP - NIS). Number and type of psychiatric diagnoses within the cohort were then evaluated using a host of ICD-10 codes. A propensity score analysis was applied to control for confounding variables such as demographics, existing comorbidities, and hospital characteristics. A binary logistic regression model was then used to identify the prediction value of psychiatric diagnosis and its interaction with modality of reconstruction for objective outcomes like length of hospital stay, treatment charge, and postoperative complications.</p></div><div><h3>Results</h3><p>A total of 10,114 patients were identified as the final cohort of breast reconstruction patients. 2621 (25.9%) patients possessed an average of 1.4 ± 0.6 existing psychiatric diagnoses. Presence of at least 1 psychiatric diagnosis was a strong predictor alone for extended length of stay (OR: 1.34, 95% CI: 1.28-1.41, <em>P</em> &lt; .001) and occurrence of postoperative complications (OR: 1.31, 95% CI: 1.21-1.41, <em>P</em> &lt; .001). Psychiatric diagnosis displayed a significant interaction with modality of breast reconstruction and conferred a lower increase in risk of extended length of stay in autologous reconstruction when compared to implant-based reconstruction (OR: 0.80, 95% CI: 0.72-0.89, <em>P</em> &lt; .001).</p></div><div><h3>Conclusion</h3><p>Existing psychiatric diagnoses were shown to strongly predict and modulate risk of adverse postoperative outcomes depending on modality of reconstruction.</p></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"24 6","pages":"Pages e474-e484.e1"},"PeriodicalIF":2.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140407782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multicenter Study on the Frequency of Low Bone Mineral Density in Young Women With Breast Cancer and Associated Factors","authors":"","doi":"10.1016/j.clbc.2024.04.012","DOIUrl":"10.1016/j.clbc.2024.04.012","url":null,"abstract":"<div><h3>Introduction</h3><p>Young women with breast cancer (BC) may experience bone mineral density (BMD) loss secondary to cancer treatment effects on estrogen levels. Studies assessing BMD in BC patients have had a limited representation of young women. This multicenter retrospective study analyzed the frequency of low BMD and associated factors in this age group.</p></div><div><h3>Methods</h3><p>Women diagnosed with stage 0-III BC at ≤40 years, treated with chemotherapy and/or endocrine therapy between 2010 and 2020 at 5 Mexican BC referral centers were eligible. Demographic, clinical and treatment data were collected, as well as bone dual-energy X-ray absorptiometry (DEXA) results. Low BMD was defined as lumbar or femoral neck T-score &lt; -1.0 or Z-score ≤ -2.0.</p></div><div><h3>Results</h3><p>A total of 1259 patients were included; median age at diagnosis was 36 years (21-40). Overall, 93% received chemotherapy and 65% endocrine therapy (tamoxifen was received at some point by 61%, aromatase inhibitors by 17%, and GnRH agonists/bilateral oophorectomy by 21%). DEXA scans were documented in 254 (20%), of which 163 (64%; 95% confidence interval [CI] 58%-70%) had a low BMD report. Low BMD was associated with receiving aromatase inhibitors (Odds ratio [OR] 1.92; 95% CI 1.13-3.24), and GnRH agonists/bilateral oophorectomy (OR 2.25; 95% CI 1.21-4.21).</p></div><div><h3>Conclusion</h3><p>The suboptimal frequency of BMD monitoring observed displays an alarming disregard for bone health in young patients. Thus, a high proportion of women with low BMD are potentially being missed and precluded from the opportunity to receive timely interventions. Particular focus should be put on BMD monitoring among patients treated with aromatase inhibitors, GnRH agonists or bilateral oophorectomy.</p></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"24 6","pages":"Pages 501-509.e2"},"PeriodicalIF":2.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141046917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Axillary Management Following Neoadjuvant Chemotherapy in Clinically Node-Positive Breast Cancer","authors":"","doi":"10.1016/j.clbc.2024.05.008","DOIUrl":"10.1016/j.clbc.2024.05.008","url":null,"abstract":"<div><h3>Introduction</h3><p>Clinical trial data indicate that omitting axillary lymph node dissection (ALND) is feasible and may reduce morbidity for carefully selected patients with clinically node-positive breast cancer who achieve a pathological complete response (pCR) after neoadjuvant chemotherapy (NCT). However, there remains a need to understand how these findings translate to broader clinical practice and to identify which patients benefit most. This study utilizes a national dataset to assess outcomes in axillary management, aiming to inform best practice in axillary de-escalation.</p></div><div><h3>Methods</h3><p>The National Cancer Data Base was used to identify women diagnosed with clinically node-positive invasive breast cancer between 2012 to 2020 who received NCT and subsequent ALND. Associations between clinicopathologic factors and axillary pCR were analyzed statistically.</p></div><div><h3>Results</h3><p>Of the 59,791 patients included, 8,827 (14.76%) achieved nodal pCR. Patients with HR-negative and HER2-positive receptor status more frequently underwent ALND instead of sentinel lymph node biopsy. Conversely, patients over the age of 70, those with private or public insurance, and cases classified as ypT1 or ypT2 were less likely to undergo ALND.</p></div><div><h3>Conclusion</h3><p>A subset of patients with clinically node-positive breast cancer received ALND despite achieving axillary pCR following NCT. This highlights an opportunity to enhance precision in identifying candidates for axillary de-escalation, potentially reducing morbidity and tailoring treatment more closely to individual patient needs.</p></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"24 6","pages":"Pages 527-532"},"PeriodicalIF":2.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141131316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re-Evaluating the Omission of Radiation Therapy in Low-Risk Patients With Early-Stage Breast Cancer","authors":"Neil D. Almeida ,&nbsp;Abigail Pepin ,&nbsp;Tyler V. Schrand ,&nbsp;Rohil Shekher ,&nbsp;Victor Goulenko ,&nbsp;Simon Fung-Kee-Fung ,&nbsp;Mark K. Farrugia ,&nbsp;Chirag Shah ,&nbsp;Anurag K. Singh","doi":"10.1016/j.clbc.2024.07.007","DOIUrl":"10.1016/j.clbc.2024.07.007","url":null,"abstract":"<div><p>Traditionally, management of early-stage breast cancer has required adjuvant radiation therapy following breast conserving surgery, due to decreased local recurrence and breast cancer mortality. However, over the past decade, there has been an increasing emphasis on potential overtreatment of patients with early-stage breast cancer. This has given rise to questions of how to optimize deintensification of treatment in this cohort of patients while maintaining clinical outcomes. A multitude of studies have focused on identification of a subset of patients with invasive breast cancer who were at low risk of local recurrence based on clinicopathologic features and therefore suitable for RT omission. These studies have failed to identify a subset that does not from RT with respect to local control. Several ongoing trials are evaluating alternative approaches to deintensification while focusing on tumor biology. With regards to ductal carcinoma in situ (DCIS), the role of RT has been questioned since breast conservation was utilized. Paralleling invasive disease studies, studies have sought to use clinicopathologic features to identify low risk patients suitable for RT omission but have failed to identify a subset that does not from RT with respect to local control. Use of new assays in patients with DCIS may represent the ideal approach for risk stratification and appropriate deintensification. At this time, when considering deintensification, individualizing treatment decisions with a focus on shared decision making is paramount.</p></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"24 7","pages":"Pages 563-574"},"PeriodicalIF":2.9,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1526820924002052/pdfft?md5=6156d2a2bd45fa92a2fa694b89c94bd9&pid=1-s2.0-S1526820924002052-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142046445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Genomic Landscape of Breast Cancer in Young and Older Women","authors":"Arielle L. Heeke ,&nbsp;Wei Sha ,&nbsp;Rebecca Feldman ,&nbsp;Julie Fisher ,&nbsp;Lejla Hadzikadic-Gusic ,&nbsp;James T. Symanowski ,&nbsp;Richard L. White Jr ,&nbsp;Antoinette R. Tan","doi":"10.1016/j.clbc.2024.07.008","DOIUrl":"10.1016/j.clbc.2024.07.008","url":null,"abstract":"<div><h3>Background</h3><p>Young women with breast cancer (YWBC; ≤40 years) often have a poorer prognosis than older women with breast cancer (OWBC; ≥65 years). We explored molecular features of tumors from YWBC and OWBC to identify a biologic connection for these patterns.</p></div><div><h3>Materials and Methods</h3><p>We retrospectively analyzed the molecular profiles of 1879 breast tumors. Testing included immunohistochemistry (IHC), <em>in situ</em> hybridization (ISH), and next-generation sequencing. Statistical analyses included Pearson's chi² test for comparisons, with significance defined as FDR (false discovery rate)-<em>P</em> &lt; .05.</p></div><div><h3>Results</h3><p><em>TP53</em> and <em>BRCA1</em> somatic mutations were more common in YWBC tumors than in OWBC tumors (53%, 42%; <em>P</em> = .0001, FDR<em>-P</em> = .0025 and 7%, 2%; <em>P</em> = .0001, FDR<em>-P</em> = .0025; respectively). Conversely, OWBC tumors had higher androgen receptor expression (55%, 45%; <em>P</em> = .0002, FDR<em>-P</em> = .0025) higher PD-L1 expression detected by IHC (8%, 5%; <em>P</em> = .0476, FDR<em>-P</em> = .2754), and more frequent <em>PIK3CA</em> mutations (33%, 17%; <em>P</em> = &lt; .0001, FDR<em>-P</em> = &lt; .0001). Among HR+/HER2- samples, YWBC had more gene amplifications in FGF3 (27%, 10%; <em>P</em> = .0353, FDR<em>-P</em> = .2462), FGF4 (27%, 9%; <em>P</em> = .0218, FDR<em>-P</em> = .1668), FGF19 (30%, 12%; <em>P</em> = .034, FDR<em>-P</em> = .2462) and CCND1 (37%, 18%; <em>P</em> = .0344, FDR<em>-P</em> = .2462) than OWBC.</p></div><div><h3>Conclusions</h3><p>Our data suggest distinct molecular aberrations exist between YWBC and OWBC. Exploiting these molecular changes could refine our treatment strategies in YWBC and OWBC.</p></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"24 7","pages":"Pages 630-638.e3"},"PeriodicalIF":2.9,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immediate Psychological Implications of Risk-Reducing Mastectomies in Women With Increased Risk of Breast Cancer: A Comparative Study","authors":"Sofía Luque Suárez ,&nbsp;María Eugenia Olivares Crespo ,&nbsp;Juana María Brenes Sánchez ,&nbsp;María Herrera de la Muela","doi":"10.1016/j.clbc.2024.07.005","DOIUrl":"10.1016/j.clbc.2024.07.005","url":null,"abstract":"<div><h3>Background</h3><p>Risk-reducing mastectomy is recommended for high-risk patients but may have significant psychological consequences. This study aimed to determine the differences in anxiety, depressive symptomatology, body image and quality of life in women with an increased risk of breast cancer immediately before and after undergoing risk-reducing mastectomy.</p></div><div><h3>Methods</h3><p>Eighty-eight women with an increased risk of breast cancer due to BRCA1/2 mutations or a previous cancer diagnosis participated in this study. Instruments used were the Hospital Anxiety and Depression Scale, Body Image Scale and the European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire Core 30 and Breast 23, administered 15-30 days before and after surgery.</p></div><div><h3>Results</h3><p>Following surgery, there was an immediate and significant worsening in anxiety, depressive symptomatology and body image. There was a significant deterioration in global, physical, role, and social functioning, as well as in body image and sexual enjoyment scales. Additionally, there were increases in fatigue, nausea and vomiting, constipation, dyspnoea, insomnia, appetite loss, perceived financial difficulties, pain, systemic therapy side effects, and breast and arm symptoms. However, there was an improvement in future perspective. These changes occurred independently of whether participants had a cancer diagnosis or BRCA1/2 mutation.</p></div><div><h3>Conclusion</h3><p>Risk-reducing mastectomies have immediate psychological consequences. While these procedures improve future health perspective, they increase anxiety and depressive symptomatology and decrease body image and quality of life, regardless of cancer diagnosis or BRCA1/2 mutation. These findings highlight the psychological consequences of such surgical procedures, emphasizing the need for comprehensive psychological interventions both before and after surgery.</p></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"24 7","pages":"Pages 620-629"},"PeriodicalIF":2.9,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1526820924002027/pdfft?md5=29d09385cd5f6b40f2130d5648b00043&pid=1-s2.0-S1526820924002027-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141839339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial Disparity in Adherence to Endocrine Therapy among Women with Early-Stage Hormone Receptor Positive Breast Cancer: An Analysis of Arkansas All-Payers Claims Database","authors":"Chenghui Li ,&nbsp;Sindhu J. Malapati ,&nbsp;Laura P. James ,&nbsp;Laura F. Hutchins","doi":"10.1016/j.clbc.2024.07.009","DOIUrl":"10.1016/j.clbc.2024.07.009","url":null,"abstract":"<div><h3>Introduction/Background</h3><p>To assess racial/ethnic disparities in endocrine therapy (ET) adherence among women with breast cancer.</p></div><div><h3>Materials and Methods</h3><p>A retrospective cohort study of Arkansas All-Payer Claims Database (APCD) linked to Arkansas Cancer Registry (ACR). Women with stages 0-3 HR+ breast cancer diagnosed in 2013-2017 were followed from cancer diagnosis for a year to determine ET initiation. Among women who initiated ETs within 1 year of diagnosis, we assessed first-year compliance (proportion of days covered ≥ 0.8) and followed them for 5 years, censoring at death, end of data availability (December 21, 2019), or disenrollment from insurance coverage, whichever occurred first, to determine time to discontinuation. Regression analysis was conducted to determine racial/ethnic disparities in ET use adjusting for patients demographic, clinical, tumor characteristics and county-level socioeconomic factors.</p></div><div><h3>Results</h3><p>Among women with continuous insurance coverage, 81% initiated ET within 1 year of diagnosis; 80% were compliant in the first year of ET use and 27.4% discontinued ET by year 5 among those who initiated ET in the first year. There were no racial/ethnic differences in ET initiation or first-year compliance adjusting for covariates. NHB women were significantly less likely to discontinue ET within 5 years after ET initiation compared to NHW women after (HR, 95% CI, 0.76, 0.58-0.98; <em>P</em> = .035).</p></div><div><h3>Conclusion</h3><p>After adjusting for patients’ and tumor characteristics, there were no racial/ethnic differences in ET initiation within 1 year of diagnosis and ET compliance within first year of ET use. However, NHB women were less likely to discontinue ET within 5 years of initiation.</p></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"24 7","pages":"Pages 647-659.e4"},"PeriodicalIF":2.9,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141840972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}