Long-Term Cause-Specific Mortality After Surgery for Women With Breast Cancer: A 20-Year Follow-Up Study From Surveillance, Epidemiology, and End Results Cancer Registries
| Autor: | Antonio Gordillo-Moscoso, Gabriel Núñez-Antonio, Alan Jiménez-Balandra, Gabriel Escarela |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Cancer Research medicine.medical_specialty Breast carcinoma Population causes of death lcsh:RC254-282 03 medical and health sciences 0302 clinical medicine Breast cancer Epidemiology Epidemiology of cancer Surveillance Epidemiology and End Results risk factors Medicine hazards models education Estrogen Receptor Status Original Research logistic model education.field_of_study business.industry risk assessment Cancer medicine.disease lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens Surgery 030104 developmental biology Oncology 030220 oncology & carcinogenesis business |
| Zdroj: | Breast Cancer: Basic and Clinical Research, Vol 11 (2017) Breast Cancer : Basic and Clinical Research |
| ISSN: | 1178-2234 |
| Popis: | Background: Research into long-term cause-specific mortality of women diagnosed with breast cancer is important because it allows for the splitting of the population into patients who eventually die from breast cancer and from other causes. The adoption of this approach helps to identify patients with an elevated risk of eventual death from breast cancer. Objective: The primary aim of this study was to examine the associations between both sociodemographic and clinicopathologic characteristics and the underlying risks of death from breast cancer and from other causes for women diagnosed with breast cancer. A second aim was to propose a predictive biomarker of cause-specific mortality in terms of treatment and several important characteristics of a patient. Methods: A cohort of 16 511 female patients diagnosed with breast cancer in 1990 was obtained from the Surveillance, Epidemiology, and End Results cancer registries and followed for 20 years. A mixture model for the regression analysis of competing risks was used to identify factors and confounders that affected either the eventual cause-specific mortality or conditional cause-specific hazard rates, or both. Missing data were handled with multiple imputation. Results: Curvilinear relationships of age at diagnosis along with race, marital status, breast cancer type, tumor size, estrogen receptor status, extension, lymph node status, type of surgery, and radiotherapy status were significant risk factors for the cause-specific mortality, with extension and lymph node status appearing to be confounded with the effects of both type of surgery and radiotherapy status. The score obtained from combining a set of predictors showed to be an accurate predictive biomarker. Conclusions: In cause-specific mortality of women diagnosed breast cancer, prognosis appears to depend on both sociodemographic and clinicopathologic factors. The predictive biomarker proposed in this study may help identifying the level of seriousness of the disease earlier than traditional methods, potentially guiding future allocation of resources for better patient care and management strategies. |
| Databáze: | OpenAIRE |
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