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Patterns of locoregional treatment for nonmetastatic breast cancer by patient and health system factors.

Publication ,  Journal Article
Anderson, RT; Morris, CR; Kimmick, G; Trentham-Dietz, A; Camacho, F; Wu, X-C; Sabatino, SA; Fleming, ST; Lipscomb, J
Published in: Cancer
March 1, 2015

BACKGROUND: The purpose of this study was to examine local definitive therapy for nonmetastatic breast cancer with the Patterns of Care Breast and Prostate Cancer (POCBP) study of the National Program of Cancer Registries (Centers for Disease Control and Prevention). METHODS: POCBP medical record data were re-abstracted in 7 state/regional registry systems (Georgia, North Carolina, Kentucky, Louisiana, Wisconsin, Minnesota, and California) to verify data quality and assess treatment patterns in the population. National Comprehensive Cancer Network clinical practice treatment guidelines were aligned with American Joint Committee on Cancer staging at diagnosis to appraise care. RESULTS: Six thousand five hundred five of 9142 patients with registry-confirmed breast cancer were coded as having primary disease with stage 0 to IIIA tumors and were included in the study. Approximately 88% received guideline-concordant locoregional treatment. However, this outcome varied by age group: 92% of women < age 50 versus 80% of women ≥ age 70 years old received guideline care (P < 0.01). Characteristics that best discriminated receipt (no/yes) of guideline-concordant care in receiver operating curve analyses were the receipt of breast-conserving surgery (BCS) versus mastectomy (C = 0.70), patient age (C = 0.62), a greater tumor stage (C = 0.60), public insurance (C = 0.58), and the presence of at least mild comorbidity (C = 0.55). Radiation therapy (RT) after BCS was the most omitted treatment component causing nonconcordance in the study population. In multivariate regression, the effects of the treatment facility, ductal carcinoma in situ, race, and comorbidity on nonconcordant care differed by age group. CONCLUSIONS: Patterns of underuse of standard therapies for breast cancer vary by age group and BCS use, with which there is a risk of omission of RT.

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Published In

Cancer

DOI

EISSN

1097-0142

Publication Date

March 1, 2015

Volume

121

Issue

5

Start / End Page

790 / 799

Location

United States

Related Subject Headings

  • United States
  • Registries
  • Practice Guidelines as Topic
  • Oncology & Carcinogenesis
  • Middle Aged
  • Medical Records
  • Mastectomy, Segmental
  • Humans
  • Guideline Adherence
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
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Anderson, R. T., Morris, C. R., Kimmick, G., Trentham-Dietz, A., Camacho, F., Wu, X.-C., … Lipscomb, J. (2015). Patterns of locoregional treatment for nonmetastatic breast cancer by patient and health system factors. Cancer, 121(5), 790–799. https://doi.org/10.1002/cncr.29092
Anderson, Roger T., Cyllene R. Morris, Gretchen Kimmick, Amy Trentham-Dietz, Fabian Camacho, Xiao-Cheng Wu, Susan A. Sabatino, Steven T. Fleming, and Joseph Lipscomb. “Patterns of locoregional treatment for nonmetastatic breast cancer by patient and health system factors.Cancer 121, no. 5 (March 1, 2015): 790–99. https://doi.org/10.1002/cncr.29092.
Anderson RT, Morris CR, Kimmick G, Trentham-Dietz A, Camacho F, Wu X-C, et al. Patterns of locoregional treatment for nonmetastatic breast cancer by patient and health system factors. Cancer. 2015 Mar 1;121(5):790–9.
Anderson, Roger T., et al. “Patterns of locoregional treatment for nonmetastatic breast cancer by patient and health system factors.Cancer, vol. 121, no. 5, Mar. 2015, pp. 790–99. Pubmed, doi:10.1002/cncr.29092.
Anderson RT, Morris CR, Kimmick G, Trentham-Dietz A, Camacho F, Wu X-C, Sabatino SA, Fleming ST, Lipscomb J. Patterns of locoregional treatment for nonmetastatic breast cancer by patient and health system factors. Cancer. 2015 Mar 1;121(5):790–799.
Journal cover image

Published In

Cancer

DOI

EISSN

1097-0142

Publication Date

March 1, 2015

Volume

121

Issue

5

Start / End Page

790 / 799

Location

United States

Related Subject Headings

  • United States
  • Registries
  • Practice Guidelines as Topic
  • Oncology & Carcinogenesis
  • Middle Aged
  • Medical Records
  • Mastectomy, Segmental
  • Humans
  • Guideline Adherence
  • Female