South Asians from India and Pakistan represent one of the fastest growing immigrant populations in the US, yet there are limited data assessing breast cancers for this distinct ethnic sub-group. The aim of this study was to analyze clinical-pathologic, treatment and outcome characteristics of U.S.-residing Indian-Pakistani (IP) versus non-Hispanic white (NHW) female breast cancer patients to assess if any differences/disparities exist. The study cohort consisted of 2,393 IP and 555,832 NHW women (diagnosed 1988–2006) in the SEER database. Differences between the two populations were analyzed using chisquared and multivariate regression analysis. Age-adjusted incidence, mortality, and relative survival rates were calculated for the two groups. Significant differences in the characteristics of the IP cohort’s invasive disease included: younger median age at presentation; larger tumor size; higher stage, higher grade, more involved lymph-nodes, and more hormone receptor negative disease (all P < 0.01). The age-adjusted incidence and breast cancer mortality were lower in IP women. The relative survival at 5 years was statistically significant at 84% for IP versus 89% for NHW women, but was not significantly different on multivariate analysis (P > 0.05). Within each stage (Tis, I, II), there were no disparities in the rate of breast conservation surgery (BCS) or in the percentage of patients receiving adjuvant radiation after BCS for the 2 cohorts. Post-mastectomy radiation was delivered significantly more often in stage I/II IP patients undergoing mastectomy. In conclusion, this analysis suggests that while there appear to be significant differences in the features of breast cancers of US-residing IP women, no disparities were noted in the rates of breast conserving surgery or adjuvant radiation, as seen in some other ethnicities. The more aggressive clinical-pathologic features stage-for-stage in IP women may partially explain the more frequent use of post-mastectomy RT in this patient population. These findings warrant further investigation.
12528 Venous Thromboembolism (VTE) is common in patients undergoing treatment for brain tumors. American College of Chest Physicians (ACCP) 2004 consensus conference recommends routine use of intermittent pneumatic compression devices (IPC), unfractionated heparin (UH) or low molecular weight heparin (LMWH) for VTE prophylaxis in these patients. There, however, continues to be a reluctance on using pharmacologic VTE prophylaxis in these patients. The goal of our study was to determine the incidence of VTE in patients with brain tumors treated at a community hospital and the frequency of use of thromboprophylaxis in these patients. Both electronic and paper charts of all patients treated for brain tumors between 1997 and 2003 were reviewed. Follow up data was obtained by contacting physicians caring for these patients. Forty two patients were identified (Anaplastic astrocytoma 10; Glioblastoma multiforme 16; Meningioma 15; oligodendroglioma 1). Twelve patients were treated with various adjuvant chemotherapy regimens. Only 16 patients (38%) received any form of VTE prophylaxis. UH (12) or LMWH (2) were used with or without IPCs or graduated compression stockings. There were eight episodes of symptomatic VTE among 42 patients (19%). These include 6 episodes of deep vein thrombosis (DVT) and two cases of superficial vein thrombosis. Three patients with DVT also had symptomatic pulmonary embolus (PE). All episodes VTE were seen in patients with malignant gliomas yielding a 29% incidence of VTE in patients with malignant gliomas. None of the 15 patients with meningioma had symptomatic VTE. All but one episode of VTE were associated with administration of systemic chemotherapy. Half of these episodes occured more than six weeks after surgical debulking. We conclude that incidence of VTE with malignant brain tumors is high (29%) and the administration of chemotherpy increases this risk. There continues to be underutilization of VTE prophylaxis in these patients at very high risk of VTE. Efforts should be directed at improving the understanding of type and duration of appropiate VTE prophylaxis in patients with brain tumors. No significant financial relationships to disclose.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.