Cause-specific mortality in long-term survivors of breast cancer: A 25-year follow-up study

Hooning, Maartje J.; Aleman, Berthe M.P.; Rosmalen, Agnes J.M. van; Kuenen, Marianne A.; Klijn, Jan G.M.; Leeuwen, Flora E. van

doi:10.1016/j.ijrobp.2005.10.022

Cited by 185 publications

(128 citation statements)

References 33 publications

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“…However, other studies showed that late mortality remained higher than unity with follow-up not exceeding 20 years [17,28]. In the series of women treated more recently, risks were lower than in our study [9]. For instance, in a recent INSERM expert report [29], excess deaths ranged from 2.4 to 4.9% during the first 12 years after breast cancer treatment among the French women diagnosed during the 1983Á1994 period.…”

Section: Other Long-term Studiescontrasting

confidence: 73%

Long-term mortality in a cohort study of 6 800 French breast cancer patients treated between 1954 and 1983

et al. 2008

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Section: Other Long-term Studiescontrasting

confidence: 73%

Long-term mortality in a cohort study of 6 800 French breast cancer patients treated between 1954 and 1983

et al. 2008

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“…Most of the patients with cardiac ischemia did not have anginal complaints. These findings are in agreement with the study of Marks et al [9], Heidenreich et al [13,14] and the Dutch Late Effects Breast Cancer Cohort, which studied the effects of cardiovascular toxicity of radiation therapy in women with breast cancer during a period of 10 years [15,16] and the SEER database [17]. The latter was a large study of women, who survived breast cancer treated with radiation therapy.…”

supporting

confidence: 89%

Cardiac perfusion screening in patients to be treated with radiation therapy in the chest, is it a must?

Baur

2009

Int J Cardiovasc Imaging

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“…However, the misclassification that can occur between the latter 2 categories does not occur with all-cause death. Also, all-cause survival to some extent captures combined effects, 24,25 because it is likely that in some cases comorbidity and breast cancer are not mutually exclusive but in combination contribute to shortened survival. Thus, survival to all-cause death serves as a useful outcome for summarising the overall impact of socioeconomic position on the cohort of breast cancer patients.…”

Section: Discussionmentioning

confidence: 99%

Influence of socioeconomic factors on survival after breast cancer—A nationwide cohort study of women diagnosed with breast cancer in Denmark 1983–1999

Dalton

Ross

Düring

et al. 2007

Intl Journal of Cancer

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The reasons for social inequality in breast cancer survival are far from established. Our study aims to study the importance of a range of socioeconomic factors and comorbid disorders on survival after breast cancer surgery in Denmark where the health care system is tax-funded and uniform. All 25,897 Danish women who underwent protocol-based treatment for breast cancer in 1983-1999 were identified in a clinical database and information on socioeconomic variables and both somatic and psychiatric comorbid disorders was obtained from population-based registries. We used Cox proportional hazards models to estimate the association between socioeconomic position and overall survival and further to analyse breast cancer specific deaths in a competing risk set-up regarding all other causes of death as competing risks. The adjusted hazard ratio (HR) for death was reduced in women with higher education (HR, 0.91; 95% confidence interval (CI), 0.85-0.98), with higher income (HR, 0.93; 95% CI, 0.87-0.98) and with larger dwellings (HR, 0.90; 95% CI, 0.85-0.96 for women living in houses larger than 150 m 2 ). Presence of comorbid disorders increased the HR. An interaction between income and comorbid disorders resulting in a 15% lower survival 10 year after primary surgery in poor women with low-risk breast cancer having comorbid conditions (65%) compared to rich women with similar breast cancer prognosis and comorbid conditions (80%) suggests that part of the explanation for the social inequality in survival after breast cancer surgery in Denmark lies in the access to and/or compliance with management of comorbid conditions in poorer women. ' 2007 Wiley-Liss, Inc.Key words: breast cancer; survival; socioeconomic position; register-based; comorbidity Overall survival of breast cancer patients has improved but unfortunately not all groups of women share these benefits equally. Although affluent women have a higher incidence of breast cancer than socially deprived women, several studies, using individual and area-based socioeconomic measures, have shown consistently that deprived women with breast cancer have poorer survival.1-13 Social inequalities in survival may involve differences in the timing of diagnosis, in the biological characteristics of the tumour, in treatments applied or in patient-specific factors, such as psychosocial factors or presence of comorbid conditions.14,15 Comorbidity in breast cancer patients limits treatment options, increases the risk of death from other causes, 16,17 and adversely affects survival. 16,18 However, the extent to which socioeconomic differences in comorbidity explain disparities in survival of breast cancer is not clear.In an earlier study, among postmenopausal Danish women, we observed, an independent effect of education, disposable income and living in rural areas on the risk of being diagnosed with a high risk breast cancer (as defined by tumour size > 20 mm, 1 or more tumour positive axillary lymph nodes, ductal tumour with grade of malignancy II or III and receptor negative statu...

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Cause-specific mortality in long-term survivors of breast cancer: A 25-year follow-up study

Cited by 185 publications

References 33 publications

Long-term mortality in a cohort study of 6 800 French breast cancer patients treated between 1954 and 1983

Long-term mortality in a cohort study of 6 800 French breast cancer patients treated between 1954 and 1983

Cardiac perfusion screening in patients to be treated with radiation therapy in the chest, is it a must?

Influence of socioeconomic factors on survival after breast cancer—A nationwide cohort study of women diagnosed with breast cancer in Denmark 1983–1999

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