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Patterns of treatment for Early-stage Breast Cancers in M. D. Anderson Cancer Center from 1997 to 2004

Identifieur interne : 002774 ( Pmc/Corpus ); précédent : 002773; suivant : 002775

Patterns of treatment for Early-stage Breast Cancers in M. D. Anderson Cancer Center from 1997 to 2004

Auteurs : Yu Shen ; Wenli Dong ; Barry W. Feig ; Peter Ravdin ; Richard L. Theriault ; Sharon H. Giordano

Source :

Cancer [ 0008-543X ] ; 2009.

RBID : PMC:2716402

Abstract

Background

This study was undertaken to examine the patterns of use for adjuvant therapy and the change in surgical practice for patients with early-stage breast cancer, and to describe how recent large clinical trial results impacted the patterns of care at M. D. Anderson Cancer Center (MDACC).

Methods

The study included 5,486 women who were diagnosed with stage I to IIIA breast cancer between 1997 and 2004 and received their treatment at MDACC. A chi-squared trend test and multivariable logistic regression model were used to assess changes in treatment patterns over time.

Results

Among node-positive patients, the use of anthracycline plus taxane chemotherapy increased from 17% in 1997 to 81% in 2004 (P < 0.001). Meanwhile, the use of anthracyclines without taxanes dropped from 76% to 20% (P <0.001) between 1997 and 2000. For postmenopausal patients receiving endocrine therapy, the use of tamoxifen has been increasingly replaced by the use of aromatase inhibitors (from 100% on tamoxifen in 1997 to 14% in 2004 (P < 0.001)). The proportion of women who received initial sentinel lymph-node biopsy increased significantly from 1997 to 2004 (1.8% to 69.7% among patients receiving mastectomy, and 18.1% to 87.1% among patients receiving breast-conserving surgery; P < 0.001).

Conclusion

The results from our study suggest that key findings in adjuvant therapy and surgical procedure from large clinical trials often prompt immediate changes in the patient care practices of research hospitals such as M. D. Anderson Cancer Center.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2716402

DOI: 10.1002/cncr.24271
PubMed: 19288569
PubMed Central: 2716402

Links to Exploration step

PMC:2716402

Le document en format XML

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<author><name sortKey="Shen, Yu" sort="Shen, Yu" uniqKey="Shen Y" first="Yu" last="Shen">Yu Shen</name>
<affiliation><nlm:aff id="A1">Department of Biostatistics, The University of Texas M. D. Anderson Cancer Center, Houston, Texas</nlm:aff>
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<author><name sortKey="Dong, Wenli" sort="Dong, Wenli" uniqKey="Dong W" first="Wenli" last="Dong">Wenli Dong</name>
<affiliation><nlm:aff id="A1">Department of Biostatistics, The University of Texas M. D. Anderson Cancer Center, Houston, Texas</nlm:aff>
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<author><name sortKey="Feig, Barry W" sort="Feig, Barry W" uniqKey="Feig B" first="Barry W." last="Feig">Barry W. Feig</name>
<affiliation><nlm:aff id="A2">Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas</nlm:aff>
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<author><name sortKey="Ravdin, Peter" sort="Ravdin, Peter" uniqKey="Ravdin P" first="Peter" last="Ravdin">Peter Ravdin</name>
<affiliation><nlm:aff id="A1">Department of Biostatistics, The University of Texas M. D. Anderson Cancer Center, Houston, Texas</nlm:aff>
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<author><name sortKey="Theriault, Richard L" sort="Theriault, Richard L" uniqKey="Theriault R" first="Richard L." last="Theriault">Richard L. Theriault</name>
<affiliation><nlm:aff id="A3">Department of Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Giordano, Sharon H" sort="Giordano, Sharon H" uniqKey="Giordano S" first="Sharon H." last="Giordano">Sharon H. Giordano</name>
<affiliation><nlm:aff id="A3">Department of Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas</nlm:aff>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Patterns of treatment for Early-stage Breast Cancers in M. D. Anderson Cancer Center from 1997 to 2004</title>
<author><name sortKey="Shen, Yu" sort="Shen, Yu" uniqKey="Shen Y" first="Yu" last="Shen">Yu Shen</name>
<affiliation><nlm:aff id="A1">Department of Biostatistics, The University of Texas M. D. Anderson Cancer Center, Houston, Texas</nlm:aff>
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<author><name sortKey="Dong, Wenli" sort="Dong, Wenli" uniqKey="Dong W" first="Wenli" last="Dong">Wenli Dong</name>
<affiliation><nlm:aff id="A1">Department of Biostatistics, The University of Texas M. D. Anderson Cancer Center, Houston, Texas</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Feig, Barry W" sort="Feig, Barry W" uniqKey="Feig B" first="Barry W." last="Feig">Barry W. Feig</name>
<affiliation><nlm:aff id="A2">Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas</nlm:aff>
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<author><name sortKey="Ravdin, Peter" sort="Ravdin, Peter" uniqKey="Ravdin P" first="Peter" last="Ravdin">Peter Ravdin</name>
<affiliation><nlm:aff id="A1">Department of Biostatistics, The University of Texas M. D. Anderson Cancer Center, Houston, Texas</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Theriault, Richard L" sort="Theriault, Richard L" uniqKey="Theriault R" first="Richard L." last="Theriault">Richard L. Theriault</name>
<affiliation><nlm:aff id="A3">Department of Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Giordano, Sharon H" sort="Giordano, Sharon H" uniqKey="Giordano S" first="Sharon H." last="Giordano">Sharon H. Giordano</name>
<affiliation><nlm:aff id="A3">Department of Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas</nlm:aff>
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<series><title level="j">Cancer</title>
<idno type="ISSN">0008-543X</idno>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title>
<p id="P1">This study was undertaken to examine the patterns of use for adjuvant therapy and the change in surgical practice for patients with early-stage breast cancer, and to describe how recent large clinical trial results impacted the patterns of care at M. D. Anderson Cancer Center (MDACC).</p>
</sec>
<sec sec-type="methods" id="S2"><title>Methods</title>
<p id="P2">The study included 5,486 women who were diagnosed with stage I to IIIA breast cancer between 1997 and 2004 and received their treatment at MDACC. A chi-squared trend test and multivariable logistic regression model were used to assess changes in treatment patterns over time.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">Among node-positive patients, the use of anthracycline plus taxane chemotherapy increased from 17% in 1997 to 81% in 2004 (P < 0.001). Meanwhile, the use of anthracyclines without taxanes dropped from 76% to 20% (P <0.001) between 1997 and 2000. For postmenopausal patients receiving endocrine therapy, the use of tamoxifen has been increasingly replaced by the use of aromatase inhibitors (from 100% on tamoxifen in 1997 to 14% in 2004 (P < 0.001)). The proportion of women who received initial sentinel lymph-node biopsy increased significantly from 1997 to 2004 (1.8% to 69.7% among patients receiving mastectomy, and 18.1% to 87.1% among patients receiving breast-conserving surgery; P < 0.001).</p>
</sec>
<sec id="S4"><title>Conclusion</title>
<p id="P4">The results from our study suggest that key findings in adjuvant therapy and surgical procedure from large clinical trials often prompt immediate changes in the patient care practices of research hospitals such as M. D. Anderson Cancer Center.</p>
</sec>
</div>
</front>
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<pmc article-type="research-article" xml:lang="EN"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
  <pmc-dir>properties manuscript</pmc-dir>
  <front><journal-meta><journal-id journal-id-type="nlm-journal-id">0374236</journal-id>
<journal-id journal-id-type="pubmed-jr-id">2771</journal-id>
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<article-id pub-id-type="doi">10.1002/cncr.24271</article-id>
<article-id pub-id-type="manuscript">NIHMS113309</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
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</article-categories>
<title-group><article-title>Patterns of treatment for Early-stage Breast Cancers in M. D. Anderson Cancer Center from 1997 to 2004</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Shen</surname>
<given-names>Yu</given-names>
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<degrees>PhD</degrees>
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<contrib contrib-type="author"><name><surname>Dong</surname>
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<degrees>MS</degrees>
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<contrib contrib-type="author"><name><surname>Feig</surname>
<given-names>Barry W.</given-names>
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<degrees>MD</degrees>
<xref ref-type="aff" rid="A2">2</xref>
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<contrib contrib-type="author"><name><surname>Ravdin</surname>
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<degrees>MD, PhD</degrees>
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<contrib contrib-type="author"><name><surname>Theriault</surname>
<given-names>Richard L.</given-names>
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<degrees>DO, MBA</degrees>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Giordano</surname>
<given-names>Sharon H.</given-names>
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<degrees>MD, MPH</degrees>
<xref ref-type="aff" rid="A3">3</xref>
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<aff id="A1"><label>1</label>
Department of Biostatistics, The University of Texas M. D. Anderson Cancer Center, Houston, Texas</aff>
<aff id="A2"><label>2</label>
Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas</aff>
<aff id="A3"><label>3</label>
Department of Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas</aff>
<author-notes><corresp id="cor1"><bold>Address for reprints:</bold>
 Yu Shen, PhD, Division of Quantitative Sciences, The University of Texas M. D. Anderson Cancer Center, P.O. Box 301402, Unit 1409, Houston, TX 77230. Phone: 713-794-4159; Fax: 713-563-4242. E-mail: <email>yshen@mdanderson.org</email>
</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>28</day>
<month>4</month>
<year>2009</year>
</pub-date>
<pub-date pub-type="ppub"><day>15</day>
<month>5</month>
<year>2009</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>27</day>
<month>7</month>
<year>2009</year>
</pub-date>
<volume>115</volume>
<issue>10</issue>
<fpage>2041</fpage>
<lpage>2051</lpage>
<abstract><sec id="S1"><title>Background</title>
<p id="P1">This study was undertaken to examine the patterns of use for adjuvant therapy and the change in surgical practice for patients with early-stage breast cancer, and to describe how recent large clinical trial results impacted the patterns of care at M. D. Anderson Cancer Center (MDACC).</p>
</sec>
<sec sec-type="methods" id="S2"><title>Methods</title>
<p id="P2">The study included 5,486 women who were diagnosed with stage I to IIIA breast cancer between 1997 and 2004 and received their treatment at MDACC. A chi-squared trend test and multivariable logistic regression model were used to assess changes in treatment patterns over time.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">Among node-positive patients, the use of anthracycline plus taxane chemotherapy increased from 17% in 1997 to 81% in 2004 (P < 0.001). Meanwhile, the use of anthracyclines without taxanes dropped from 76% to 20% (P <0.001) between 1997 and 2000. For postmenopausal patients receiving endocrine therapy, the use of tamoxifen has been increasingly replaced by the use of aromatase inhibitors (from 100% on tamoxifen in 1997 to 14% in 2004 (P < 0.001)). The proportion of women who received initial sentinel lymph-node biopsy increased significantly from 1997 to 2004 (1.8% to 69.7% among patients receiving mastectomy, and 18.1% to 87.1% among patients receiving breast-conserving surgery; P < 0.001).</p>
</sec>
<sec id="S4"><title>Conclusion</title>
<p id="P4">The results from our study suggest that key findings in adjuvant therapy and surgical procedure from large clinical trials often prompt immediate changes in the patient care practices of research hospitals such as M. D. Anderson Cancer Center.</p>
</sec>
</abstract>
<kwd-group><kwd>breast cancer</kwd>
<kwd>chemotherapy</kwd>
<kwd>endocrine/hormone therapy</kwd>
<kwd>sentinel lymph-node biopsy</kwd>
</kwd-group>
<contract-num rid="CA1">R01 CA079466-09
				||CA</contract-num>
<contract-sponsor id="CA1">National Cancer Institute  : NCI</contract-sponsor>
</article-meta>
</front>
</pmc>
</record>

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Patterns of treatment for Early-stage Breast Cancers in M. D. Anderson Cancer Center from 1997 to 2004

Patterns of treatment for Early-stage Breast Cancers in M. D. Anderson Cancer Center from 1997 to 2004

Source :

Abstract

Links to Exploration step

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