Substantial increase in the use of adjuvant systemic treatment for early stage breast cancer reflects changes in guidelines in the period 1990-2006 in the southeastern Netherlands
- PMID: 18640030
- DOI: 10.1016/j.ejca.2008.06.001
Substantial increase in the use of adjuvant systemic treatment for early stage breast cancer reflects changes in guidelines in the period 1990-2006 in the southeastern Netherlands
Abstract
Background: This study evaluated trends in adjuvant systemic treatment among breast cancer patients and analyzed the factors on which treatment choice was based.
Patients and methods: Patients diagnosed with early stage breast cancer in 1990-2006 were selected from the registry of the Comprehensive Cancer Centre South (n=8261). The probability of receiving therapy was determined per characteristic for the periods 1990-1997, 1998-2001 and 2002-2006, separately.
Results: The use of any adjuvant systemic treatment increased from 37% in 1990-1997 to 51% in 1998-2001 and 53% in 2002-2006 (p for trend < 0.0001). In the period 1990-1997, lymph node status (positive vs. negative: probability ratio (PR=25.8; 95% CI, 16.5-40.4) and age ( 60 vs. 35 years: PR=0.01; 95% CI, 0.00-0.02) were the main determinants of the likelihood of receiving chemotherapy. From 1998 onwards, age remained the most important factor in decreasing the likelihood of receiving chemotherapy. During 1990-1997 the use of hormonal therapy was mainly determined by positive lymph node status (PR=35; 95% CI, 25-49) and age ( 70 vs. 35 years: PR=9.3; 95% CI, 4.4-20), whereas positive hormone receptor status mainly affected hormonal therapy use (PR=17; 95% CI, 10-28) in the period 2002-2006. Marked differences were observed between hospitals in the adoption of adjuvant systemic treatment for node-negative patients.
Conclusions: The impact of patient and tumour characteristics on treatment choice varied over time, reflecting major changes in the Dutch treatment guidelines. Patients older than 70 years received almost no chemotherapy.
Similar articles
-
Improved survival for women with stage I breast cancer in south-east Sweden: a comparison between two time periods before and after increased use of adjuvant systemic therapy.Acta Oncol. 2009;48(4):504-13. doi: 10.1080/02841860902718754. Acta Oncol. 2009. PMID: 19235568
-
[Determining factors for adjuvant treatment of breast cancer in the Côte d'Or region 1982-1990. Registry of gynecologic cancers at the Côte d'Or].Bull Cancer. 1996 Jan;83(1):54-62. Bull Cancer. 1996. PMID: 8672857 French.
-
Co-expression of estrogen receptor alpha and Apolipoprotein D in node positive operable breast cancer--possible relevance for survival and effects of adjuvant tamoxifen in postmenopausal patients.Acta Oncol. 2009;48(4):514-21. doi: 10.1080/02841860802620613. Acta Oncol. 2009. PMID: 19107621
-
Adjuvant chemotherapy in elderly patients with early breast cancer. Impact of age and comprehensive geriatric assessment on tumor board proposals.Crit Rev Oncol Hematol. 2011 Aug;79(2):196-204. doi: 10.1016/j.critrevonc.2010.06.005. Epub 2010 Jul 23. Crit Rev Oncol Hematol. 2011. PMID: 20655243 Review.
-
[Early-stage breast cancer - strategies for adjuvant systemic therapy].Handchir Mikrochir Plast Chir. 2008 Aug;40(4):230-8. doi: 10.1055/s-2008-1038926. Epub 2008 Aug 20. Handchir Mikrochir Plast Chir. 2008. PMID: 18716990 Review. German.
Cited by
-
Differences in dietary intake during chemotherapy in breast cancer patients compared to women without cancer.Support Care Cancer. 2017 Aug;25(8):2581-2591. doi: 10.1007/s00520-017-3668-x. Epub 2017 Mar 16. Support Care Cancer. 2017. PMID: 28303381 Free PMC article.
-
A longitudinal mixed methods study on changes in body weight, body composition, and lifestyle in breast cancer patients during chemotherapy and in a comparison group of women without cancer: study protocol.BMC Cancer. 2019 Jan 5;19(1):7. doi: 10.1186/s12885-018-5207-7. BMC Cancer. 2019. PMID: 30611243 Free PMC article.
-
Chemotherapy-induced peripheral neuropathy and its association with quality of life: a systematic review.Support Care Cancer. 2014 Aug;22(8):2261-9. doi: 10.1007/s00520-014-2255-7. Epub 2014 May 1. Support Care Cancer. 2014. PMID: 24789421 Review.
-
Risk factors of unmet needs among women with breast cancer in the post-treatment phase.Psychooncology. 2020 Mar;29(3):539-549. doi: 10.1002/pon.5299. Epub 2019 Dec 16. Psychooncology. 2020. PMID: 31785043 Free PMC article.
-
Disparities in breast cancer mortality trends between 30 European countries: retrospective trend analysis of WHO mortality database.BMJ. 2010 Aug 11;341:c3620. doi: 10.1136/bmj.c3620. BMJ. 2010. PMID: 20702548 Free PMC article.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical
Research Materials