Estimating the incidence of breast cancer recurrence using administrative data

Habbous, Steven; Barisic, Andriana; Homenauth, Esha; Kandasamy, Sharmilaa; Förster, Katharina; Eisen, Andrea; Holloway, Claire

doi:10.1007/s10549-022-06812-z

Cited by 4 publications

(5 citation statements)

References 35 publications

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Section: Methodsmentioning

confidence: 99%

“…Patients with active breast cancer at the time of their initial genitourinary syndrome of menopause diagnosis, defined as those receiving radiation oncology treatment (CPT 1010843, 63620, 63621), chemotherapy (TriNet Curated Code 1002, Veterans Affairs code 56946 paclitaxel, 253337 bevacizumab, 194000 capecitabine, 2555 cisplatin, 1045453 eribulin, 4179 etoposide, 282357 fulvestrant, 12574 gemcitabine, 480167 lapatinib, 1601374 palbociclib, 1298944 pertuzumab, 224905 trastuzumab, 39541 vinorelbine, 72962 docetaxel, or 3639 doxorubicin), or mastectomy (1014812,(19303)(19304)(19305)(19306)(19307); International Classification of Diseases, Ninth Revision 85.33-85.36, 85.40-85.48), within 3 months before their initial diagnosis of genitourinary syndrome of menopause were also excluded. 8,9 The primary study outcome was breast cancer recurrence, defined as the need for mastectomy, radiation, or chemotherapy, or occurrence of secondary malignancy (ie, breast cancer metastasis) (ICD-10 C77, C78, C79.1-C79.7, C79.82, C79.89, C79.9) within 3 months to 5 years after initiation vaginal estrogen therapy for genitourinary syndrome of menopause. 8,9 A 1:1 matching was performed depending on the propensity scores generated by TriNetX by greedynearest-neighbor algorithms with a caliper width of 0.1 pooled SD.…”

Section: Methodsmentioning

confidence: 99%

“…8,9 The primary study outcome was breast cancer recurrence, defined as the need for mastectomy, radiation, or chemotherapy, or occurrence of secondary malignancy (ie, breast cancer metastasis) (ICD-10 C77, C78, C79.1-C79.7, C79.82, C79.89, C79.9) within 3 months to 5 years after initiation vaginal estrogen therapy for genitourinary syndrome of menopause. 8,9 A 1:1 matching was performed depending on the propensity scores generated by TriNetX by greedynearest-neighbor algorithms with a caliper width of 0.1 pooled SD. To alleviate bias ensuing from nearest-neighbor algorithms, TriNetX randomizes the order of rows.…”

Section: Methodsmentioning

confidence: 99%

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Safety of Vaginal Estrogen Therapy for Genitourinary Syndrome of Menopause in Women With a History of Breast Cancer

Agrawal

Singh

Able

et al. 2023

Obstetrics &Amp; Gynecology

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OBJECTIVE: To assess the risk of recurrence of breast cancer associated with vaginal estrogen therapy in women diagnosed with genitourinary syndrome of menopause with a history of breast cancer using a large U.S. claims database. METHODS: A U.S. health research network (TriNetX Diamond Network) was queried from January 2009 to June 2022. Our cohort consisted of women diagnosed with breast cancer within 5 years before the initial genitourinary syndrome of menopause diagnosis. Patients with active disease, defined as those undergoing mastectomy, radiation treatment, or chemotherapy within 3 months before diagnosis of genitourinary syndrome of menopause, were excluded. Recurrence was defined as mastectomy, radiation, chemotherapy, or secondary malignancy within 3 months to 5 years after the initiation of vaginal estrogen therapy for genitourinary syndrome of menopause. The study cohort included those with three or more vaginal estrogen prescriptions. The control cohort included women with breast cancer without any vaginal estrogen prescriptions after genitourinary syndrome of menopause diagnosis. Propensity matching was performed. A subanalysis by positive estrogen receptor status, when available, was performed. RESULTS: We identified 42,113 women with a diagnosis of genitourinary syndrome of menopause after breast cancer diagnosis with any estrogen receptor status, 5.0% of whom received vaginal estrogen. Of the initial cohort, 10,584 patients had a history of positive estrogen receptor breast cancer, and 3.9% of this group received vaginal estrogen. Risk of breast cancer recurrence was comparable between those who received vaginal estrogen and those who did not in both the any estrogen receptor (risk ratio 1.03, 95% CI 0.91–1.18) and positive estrogen receptor (risk ratio 0.94, 95% CI 0.77–1.15) status analyses. CONCLUSION: In a large, claims-based analysis, we did not find an increased risk of breast cancer recurrence within 5 years in women with a personal history of breast cancer who were using vaginal estrogen for genitourinary syndrome of menopause.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Safety of Vaginal Estrogen Therapy for Genitourinary Syndrome of Menopause in Women With a History of Breast Cancer

Agrawal

Singh

Able

et al. 2023

Obstetrics &Amp; Gynecology

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“…Most previous studies measuring progression to DM across BC patient populations have used healthcare datasets, with PBCR studies rare and concentrated in a small number of countries (Belgium, Canada, Denmark, and USA) (11,(20)(21)(22)(23)(24)(25)(26)(27). In these studies, expert-driven rule-based or model-based algorithms have been developed but few studies have used population-based data and validated their algorithm against a gold standard dataset of known con rmed patients with BCDM (21,22,24,27,28).…”

Section: Introductionmentioning

confidence: 99%

Development and validation of an algorithm to estimate incidence and prevalence of breast cancer patients with distant metastasis in Northern Ireland: A population-based study

Hawkins,

Ashok,

Kelly

et al. 2024

Preprint

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Introduction: The lack of systematic collection and reporting of breast cancer with distant metastasis (BCDM) means incidence and prevalence is largely unknown. Methods: Patients with primary breast cancer (BC) (Stage I-III and “Stage not known”) and de novo patients (Stage IV at diagnosis) were identified from the Northern Ireland Cancer Registry and linked to hospital inpatient (PAS) and death records (GRO) over the period 1993 to 2020. An expert rules-based algorithm was developed to identify BCDM cases. This was validated using a dataset of 1,028 BC patients diagnosed in 2009 and followed up until 2017 for BCDM (184 BCDM cases). Sensitivity, specificity, positive and negative predictive values (PPV, NPV) were calculated, and incident and prevalent cases reported. Results: Validation demonstrated high sensitivity (95.1%), specificity (99.2%), PPV (96.2%) and NPV (98.9%). Between 2009–2020 incident cases were stable, averaging 254 per year, while the prevalent population increased from 587 to 911 (55% increase), suggesting improved survivorship. In 2020 the highest proportion of patients living with BCDM were existing cases from previous years (71.2%), with 66.6% having progressive BCDM and 33% de novo BCDM. Conclusion: The novel algorithm accurately identified BCDM cases which will help planning, care and support for BCDM patients.

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“…Breast cancer remains the most common non-cutaneous malignancy in women, with an estimated 2.26 million cases diagnosed worldwide annually [1]. Although locoregional recurrence rates are low in patients receiving modern multidisciplinary treatment for nonmetastatic breast cancer, the risk for recurrence or the development of a new primary breast cancer can persist for many years after definitive treatment [2][3][4]. While the relative risk of breast cancer recurrence is overall low, the number of patients represented is a significant 2 of 15 population given the high overall incidence of the disease.…”

Section: Introductionmentioning

confidence: 99%

Proton Reirradiation for High-Risk Recurrent or New Primary Breast Cancer

Chakraborty,

Khan,

Cahlon

et al. 2023

Cancers

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Radiotherapy is an integral component of multidisciplinary breast cancer care. Given how commonly radiotherapy is used in the treatment of breast cancer, many patients with recurrences have received previous radiotherapy. Patients with new primary breast cancer may also have received previous radiotherapy to the thoracic region. Curative doses and comprehensive field photon reirradiation (reRT) have often been avoided in these patients due to concerns for severe toxicities to organs-at-risk (OARs), such as the heart, lungs, brachial plexus, and soft tissue. However, many patients may benefit from definitive-intent reRT, such as patients with high-risk disease features such as lymph node involvement and dermal/epidermal invasion. Proton therapy is a potentially advantageous treatment option for delivery of reRT due to its lack of exit dose and greater conformality that allow for enhanced non-target tissue sparing of previously irradiated tissues. In this review, we discuss the clinical applications of proton therapy for patients with breast cancer requiring reRT, the currently available literature and how it compares to historical photon reRT outcomes, treatment planning considerations, and questions in this area warranting further study. Given the dosimetric advantages of protons and the data reported to date, proton therapy is a promising option for patients who would benefit from the added locoregional disease control provided by reRT for recurrent or new primary breast cancer.

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Estimating the incidence of breast cancer recurrence using administrative data

Cited by 4 publications

References 35 publications

Safety of Vaginal Estrogen Therapy for Genitourinary Syndrome of Menopause in Women With a History of Breast Cancer

Safety of Vaginal Estrogen Therapy for Genitourinary Syndrome of Menopause in Women With a History of Breast Cancer

Development and validation of an algorithm to estimate incidence and prevalence of breast cancer patients with distant metastasis in Northern Ireland: A population-based study

Proton Reirradiation for High-Risk Recurrent or New Primary Breast Cancer

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