Prognosis in Women with Breast Cancer and Private Extra Insurance Coverage

Abstract

BackgroundMany women covered by the Spanish public health system also have an extra private insurance policy for gynecological examinations and routine annual mammography. We retrospectively analyzed the long-term survival rates in these patients when diagnosed with breast cancer.MethodsWe analyzed the survival and prognostic factors in patients diagnosed with breast cancer who were referred to a medical oncology unit for multidisciplinary treatment covered by private health insurance.ResultsBetween 1994 and 2009, a total of 434 patients with breast tumor were analyzed: 33 in situ and 401 infiltrating. Among the infiltrating carcinomas, 38 were stage IV and 363 were stage I, II, or III. With a median follow-up of 62 months, the 5-year global survival rate was 91 %: 97 % for stage I, 94 % for stage II, and 77 % for stage III tumors. In the patients diagnosed by routine mammography, the 5-year survival rate was 96 %, compared with 86 % in those consulting their gynecologist after breast self-examination or for other symptoms (p = 0.0159). Seventy-four percent were treated conservatively and experienced better survival than the 26 % who underwent mastectomy (p = 0.0024). Patients with disease with positive hormone receptors had a better survival rate (p = 0.0264); hormone receptor status was the only independent prognostic factor in the Cox multivariate analysis. Postmenopausal patients who received adjuvant tamoxifen plus exemestane had a better prognosis than those who received tamoxifen alone (p = 0.0203).ConclusionsLong-term survival rate was high in breast cancer patients with extra private insurance coverage. This is probably because disease was diagnosed at an early stage.

Ursolic acid inhibits breast cancer growth by inhibiting proliferation, inducing autophagy and apoptosis, and suppressing inflammatory responses via the PI3K/AKT and NF-κB signaling pathways in vitro

“…It has been reported that breast cancer, which is the most common cancer in females across the world, accounts for ~25% of all female malignancies and has a higher incidence in developed countries ( 1 , 2 ). Furthermore, breast cancer is reportedly the second leading cause of cancer-associated mortality among females worldwide ( 3 ). Breast cancer is typically treated by surgical resection, which may be followed up by chemotherapy, radiation therapy or both ( 4 ).…”

Prognostic influence of Korean public medical insurance system on breast cancer patients

“…It has been reported that older minority women without health insurance or insured by Medicare and Medicaid face challenges in receiving optimal care for breast cancer [4]. The relationship between medical insurance system and prognosis of cancer patients has been reported in various cancers, including breast cancer [5], head and neck cancer [6], Hodgkin lymphoma [7], germ cell tumors [8], colorectal cancer [9], childhood cancer [10], and cancers in young adults [11]. Recently, Ellis et al [12] have analyzed data of 1,149,891 cancer patients from California Cancer Registry and reported that survival improvements are exclusively limited to patients with private or Medicare insurance while survival for patients with other public insurance or no insurance is largely unchanged or declined.…”

Breast cancer data analysis for survivability studies and prediction

“…Based on the types and stage of the cancer, treatment modalities outcomes could vary. For example, it was found that breast cancer, limited to first stage only, 96% of patients will be alive in five years after diagnosis [3]. Spread to regional nodes or other nodes and distant metastasis will reduce the survivability.…”