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Member Research & Reports

Member Research & Reports

LSU: Population-Based Study on Cancer Subtypes, Guideline-Concordant Adjuvant Therapy, and Survival Among Women With Stage I–III Breast Cancer

Breast cancer subtype is a key determinant in treatment decision-making, and also effects survival outcome. Dr. Mei-Chin Hsieh and a team of researchers from the Louisiana State University Health Sciences Center School of Public Health (LSUHSC SoPH) analyzed and performed a population based study to examine the impact that breast cancer subtype and receipt of guideline-concordant adjuvant systemic therapy (AST) have on survival using a population-based cancer registry’s data. Women aged ≥20 years with microscopically confirmed stage I–III breast cancer diagnosed in 2011 were identified from the Louisiana Tumor Registry. Breast cancer subtypes were categorized based on hormone receptor (HR) and HER2 status. Guideline-concordant treatment was defined using the National Comprehensive Cancer Network (NCCN) Guidelines for Breast Cancer. Logistic regression was applied to identify factors associated with guideline-concordant aspartate aminotransferase (AST) receipt. Kaplan-Meier survival curves were generated to compare survival among subtypes by AST receipt status, and a semiparametric additive hazard model was used to verify the factors impacting survival outcome. Of 2,214 eligible patients, most (70.8 percent) were HR+/HER2– followed by HR–/HER2– (14.4 percent, and 78.6 percent received guideline-concordant AST. Compared with patients with the HR+/HER2+ subtype, women with other subtypes were more likely to be guideline-concordant after adjusting for sociodemographic and clinical variables. Women with the HR–/HER2+ or HR–/HER2– subtype had a higher risk of any-cause and breast cancer–specific death than those with the HR+/HER2+ subtype. The team concluded that patients receiving guideline-adherent adjuvant therapy had better survival outcomes across all breast cancer subtypes.

Full article.

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