Abstract：
BACKGROUND:We have developed a decision analysis model that uses the results of available randomized controlled trials to model the natural history of early breast cancer and assess the potential clinical and financial effects of using adjuvant therapies. PATIENTS AND METHODS:The original model was used to assess the impact of chemotherapy in hypothetical groups of 45-year-old and 60-year-old node-negative, estrogen receptor-negative women. Using the 1992 Early Breast Cancer Trialists' Collaborative Group report, we have expanded and revised the model to assess: 1) the role of tamoxifen alone, chemotherapy alone, or combined therapy in pre-menopausal women, and 2) chemotherapy in elderly women with node-negative, estrogen receptor-negative cancer. RESULTS:For pre-menopausal women, we found that chemotherapy increases quality adjusted life expectancy and survival by a substantial amount at a cost less than most accepted medical interventions. Combined therapy is beneficial and cost-effective in estrogen receptor-positive cancer. For the elderly, chemotherapy prolongs survival but to a lesser extent compared to younger women. The cost of this benefit is high but within the range of commonly reimbursed procedures for women under age 75 without other co-existing conditions. CONCLUSIONS:For most patients some form of adjuvant therapy is beneficial and cost-effective. The model builds upon the data derived from collaborative efforts assessing the effectiveness of adjuvant therapies. The model highlights the need for an equal commitment to assessing the economic and quality of life impacts of breast cancer treatments.
journal_name
Breast Cancer Res Treatjournal_title
Breast cancer research and treatmentauthors
Hillner BE,Smith TJ,Desch CEdoi
10.1007/BF00662134subject
Has Abstractpub_date
1993-01-01 00:00:00pages
97-105issue
2eissn
0167-6806issn
1573-7217journal_volume
25pub_type
杂志文章abstract：:Cytosolic glutathione S-transferase comprises multiple isoenzymes; studies have principally examined mu-1 (GSTM1: null/present), theta-1 (GSTT1: null/present) and pi-1 (GSTP1 Ile105Val) gene polymorphisms concerning breast cancer risk. Regarding GSTT1 and GSTP1 polymorphisms, studies remain controversial and no recent...
journal_title：Breast cancer research and treatment
pub_type： 杂志文章,meta分析
doi：10.1007/s10549-009-0520-0
更新日期：2010-05-01 00:00:00
abstract：:Cell migration is essential in many diverse processes ranging from embryonic development to wound healing and immune response. Cancer cells have recently been shown to utilize chemoattraction mechanisms mediated by chemokines and their respective receptors, e.g., the CXCL12/CXCR4 pathway normally found in leukocytes. ...
journal_title：Breast cancer research and treatment
pub_type： 杂志文章
doi：10.1007/s10549-007-9504-0
更新日期：2007-12-01 00:00:00
abstract：PURPOSE:PARP4 has been proposed as a candidate breast cancer susceptibility gene. However, its function and involvement in breast carcinogenesis is unclear. We sought to determine the variant frequency of PARP4 in BRCA-negative women referred for genetic testing from Singapore and to perform functional analyses of PARP...
journal_title：Breast cancer research and treatment
pub_type： 杂志文章
doi：10.1007/s10549-019-05286-w
更新日期：2019-08-01 00:00:00
abstract：:Sentinel lymph node (SLN) biopsy is rapidly emerging as an alternative to axillary lymph node dissection (ALND) for many female breast cancer patients. In contrast, ALND remains the standard of care for male breast cancer patients with similar tumors. We evaluated the results of SLN biopsy in male breast cancer patien...
journal_title：Breast cancer research and treatment
pub_type： 杂志文章
doi：10.1023/a:1021173902253
更新日期：2003-01-01 00:00:00
abstract：:The purpose of this article is to comprehensively summarize the associations between carotenoids and breast cancer and quantitatively estimate their dose-response relationships. We searched PubMed, Embase, and Cochrane databases (from January 1982 to 1 May 2011) and the references of the relevant articles in English w...
journal_title：Breast cancer research and treatment
pub_type： 杂志文章,meta分析
doi：10.1007/s10549-011-1723-8
更新日期：2012-01-01 00:00:00
abstract：BACKGROUND:High insulin levels have been associated with poor outcomes in breast cancer. Our goal was to investigate whether hyperinsulinemia was associated with insulin resistance in a cohort of newly diagnosed locoregional breast cancer patients and to examine associations of hyperinsulinemia with the broader insulin...
journal_title：Breast cancer research and treatment
pub_type： 杂志文章
doi：10.1007/s10549-008-0019-0
更新日期：2009-04-01 00:00:00
abstract：:To assess the impact of patient-provider communication on adherence to tamoxifen (TAM) and aromatase inhibitors (AIs) 36 months after breast cancer (BC) diagnosis in a low-income population of women. California statewide surveys were conducted among 921 low-income women with BC at 6, 18, and 36 months after BC diagnos...
journal_title：Breast cancer research and treatment
pub_type： 杂志文章
doi：10.1007/s10549-012-2387-8
更新日期：2013-02-01 00:00:00
abstract：:BRCA1 protein is normally expressed in the nuclei of breast epithelial cells and functions as a negative regulator of the cell cycle. Mutations of BRCA1 gene have been associated with familial breast carcinomas. Although somatic mutations have not been demonstrated in sporadic breast carcinomas, loss of nuclear expres...
journal_title：Breast cancer research and treatment
pub_type： 杂志文章
doi：10.1023/a:1013317909431
更新日期：2002-01-01 00:00:00
abstract：:NSABP B-43 is the first prospective, randomized phase III multi-institution clinical trial targeting high-risk, HER2-positive DCIS. It compares whole breast irradiation alone with WBI given concurrently with trastuzumab in women with HER2-positive DCIS treated by lumpectomy. The primary aim is to determine if trastuzu...
journal_title：Breast cancer research and treatment
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1007/s10549-013-2755-z
更新日期：2013-11-01 00:00:00
abstract：:Following mastectomy, patients with operable breast cancer underwent postoperative irradiation of the chest wall and regional lymph nodes. They were then assigned at random to receive no further therapy, ovarian irradiation (2000 rad in five days) or ovarian irradiation in the same dosage plus prednisone, 7.5 mg daily...
journal_title：Breast cancer research and treatment
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1007/BF01855127
更新日期：1983-01-01 00:00:00
abstract：:The research question of this investigation is whether the reduction rate of Ki-67 after neoadjuvant chemotherapy (NAC) could indicate a survival in patients with non-pCR. A total of 455 patients had received NAC, and subsequent surgery was analyzed retrospectively. Patients with non-pCR were divided into three subgro...
journal_title：Breast cancer research and treatment
pub_type： 杂志文章
doi：10.1007/s10549-014-3084-6
更新日期：2014-08-01 00:00:00
abstract：BACKGROUND:Anastrozole, a new aromatase inhibitor, has been used to treat postmenopausal metastatic breast cancer, and several clinical trials of adjuvant treatment using this agent are ongoing. However, the effects of anastrozole on lipid metabolism are unknown. The aim of this study was to evaluate the effect of anas...
journal_title：Breast cancer research and treatment
pub_type： 杂志文章
doi：10.1023/a:1020571617274
更新日期：2002-11-01 00:00:00
abstract：:The enumeration of circulating tumor cells (CTCs) provides important prognostic values in patients with metastatic breast cancer. Recent studies indicate that individual CTCs form clusters and these CTC-clusters play an important role in tumor metastasis. We aimed to assess whether quantification of CTC-clusters provi...
journal_title：Breast cancer research and treatment
pub_type： 杂志文章
doi：10.1007/s10549-015-3636-4
更新日期：2015-12-01 00:00:00
abstract：:Genetic risk prediction models such as BRCAPRO are used routinely in genetic counseling for identification of potential BRCA1 and BRCA2 mutation carriers. They require extensive information on the counselee and her family history, and thus are not practical for primary care. To address this gap, we develop and test a ...
journal_title：Breast cancer research and treatment
pub_type： 杂志文章
doi：10.1007/s10549-016-3686-2
更新日期：2016-01-01 00:00:00
abstract：PURPOSE:The American Society of Clinical Oncology recommends concurrent palliative care (PC) for patients with metastatic cancer. Recent data show benefits of early PC (at least 90 days before death). However, little is known about PC among patients who die from metastatic breast cancer. METHODS:Patients with metastat...
journal_title：Breast cancer research and treatment
pub_type： 临床试验,杂志文章
doi：10.1007/s10549-017-4556-2
更新日期：2018-02-01 00:00:00
abstract：BACKGROUND:Telomerase is a ribonucleoprotein enzyme that synthesises telomeres in human germ cells, embryogenesis and in cancer, maintaining chromosomal length, stability and cellular immortality. The hTERT gene is the rate-limiting determinant of telomerase reactivation during immortalization and malignant transformat...
journal_title：Breast cancer research and treatment
pub_type： 杂志文章
doi：10.1007/s10549-007-9622-8
更新日期：2008-05-01 00:00:00
abstract：:Seroma formation after axillary lymphadenectomy in women with breast cancer remains a problem despite many efforts to reduce surgery-related morbidity. In a prospective, randomised, open, parallel-group, controlled clinical trial we evaluated the effect of a fibrin-glue coated collagen patch (TachoComb H, Nycomed Phar...
journal_title：Breast cancer research and treatment
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1023/a:1010671209279
更新日期：2001-05-01 00:00:00
abstract：:Fulvestrant fIRst-line Study comparing endocrine Treatments is a phase II, randomized, open-label study comparing fulvestrant 500 mg with anastrozole 1 mg as first-line endocrine therapy for postmenopausal women with hormone receptor-positive (HR+) advanced breast cancer. At data cut-off, only 36 % of patients had pro...
journal_title：Breast cancer research and treatment
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1007/s10549-012-2192-4
更新日期：2012-11-01 00:00:00
abstract：:Growth, progression, and metastasis of breast cancer, as well as of most of the other tumors, are angiogenesis-dependent processes. Several pro-angiogenic growth factors and endogenous inhibitors of angiogenesis have been identified and sequenced, and experimental studies suggest that angiogenic activity of a tumor ma...
journal_title：Breast cancer research and treatment
pub_type： 杂志文章,评审
doi：10.1023/a:1006175504673
更新日期：1998-01-01 00:00:00
abstract：BACKGROUND:The aim was to prove the low identification rate of sentinel lymph node biopsy (SNB) and to determine the feasibility of replacing axillary lymph node dissection (AND) in axillary lymph node positive patients after chemotherapy. METHODS:From October 2001 to July 2005, 875 consecutive patients with primary o...
journal_title：Breast cancer research and treatment
pub_type： 临床试验,杂志文章
doi：10.1007/s10549-006-9330-9
更新日期：2007-05-01 00:00:00
abstract：:Ductal carcinoma in situ (intraductal carcinoma) of the breast is a commonly recognized and curable clinical entity. Patients with intraductal carcinoma are at risk to develop invasive breast cancer presumably due to a transition from the noninvasive to the invasive phase of growth. Primary breast malignancies commonl...
journal_title：Breast cancer research and treatment
pub_type： 杂志文章
doi：10.1007/BF00689717
更新日期：1995-06-01 00:00:00
abstract：:The growth hormone and insulin-like growth factor (IGF) axis plays an essential role in the growth and development of the mammary gland. IGF1 and IGF1 receptor (IGF1R) may also play a role in the early transformation of mammary cells. Using a nested case-control design, the association between IGF1R expression in norm...
journal_title：Breast cancer research and treatment
pub_type： 杂志文章
doi：10.1007/s10549-010-1313-1
更新日期：2011-07-01 00:00:00
abstract：:Aromatase inhibitors (AIs) are used for treatment of estrogen receptor α (ER)-positive breast cancer; however, resistance is a major obstacle for optimal outcome. This preclinical study aimed at identifying potential new treatment targets in AI-resistant breast cancer cells. Parental MCF-7 breast cancer cells and four...
journal_title：Breast cancer research and treatment
pub_type： 杂志文章
doi：10.1007/s10549-015-3284-8
更新日期：2015-02-01 00:00:00
abstract：:Decreased CYP2D6 activity is associated with lower levels of active tamoxifen metabolites. We examined the impact of CYP2D6 genotype on tamoxifen pharmacokinetics, biomarker activity, and efficacy in a pooled analysis of low-dose tamoxifen. Four randomized breast cancer prevention trials of very-low-dose (1 mg/day, n ...
journal_title：Breast cancer research and treatment
pub_type： 杂志文章
doi：10.1007/s10549-016-3932-7
更新日期：2016-08-01 00:00:00
abstract：:Epidermal growth factor receptor (EGFr) levels were analyzed in 140 primary breast cancer specimens by immunohistochemical assay (ICA), competitive binding assay (BA), or enzyme immunoassay (EIA). Thirty-nine of 118 specimens (33.1%) were scored as positive by ICA, 30 of 116 (25.9%; cut-off level 10 fmol/mg protein) b...
journal_title：Breast cancer research and treatment
pub_type： 杂志文章
doi：10.1007/BF00666582
更新日期：1993-12-01 00:00:00
abstract：:Breast cancer is the most common cancer among women. It is estimated that 7% of women who have breast cancer will develop a subsequent second independent breast tumor within 10 years of the first. The status of estrogen (ER), progesterone (PR) and human growth hormone (HER2) receptors, individually and as phenotypic c...
journal_title：Breast cancer research and treatment
pub_type： 杂志文章
doi：10.1007/s10549-009-0469-z
更新日期：2010-02-01 00:00:00
abstract：:Adjuvant cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) have proven highly effective in rapidly proliferating breast cancer (RPBC). It has also been seen that sequential administration of doxorubicin and CMF is superior to their alternation, especially in indolent tumors. In a phase III study, we evaluated w...
journal_title：Breast cancer research and treatment
pub_type： 杂志文章,随机对照试验
doi：10.1007/s10549-010-1257-5
更新日期：2011-02-01 00:00:00
abstract：:Current evidence suggests that the majority of DCIS lesions do not progress to invasive carcinoma, and overtreatment of DCIS is a significant problem. We previously reported an 8-gene signature that differentiated microdissected low-grade (LG) DCIS lesions with and without associated stromal invasion, based on differe...
journal_title：Breast cancer research and treatment
pub_type： 杂志文章
doi：10.1007/s10549-016-3838-4
更新日期：2016-06-01 00:00:00
abstract：:A number of endocrine treatments for advanced breast cancer seem to affect serum insulin-like growth factor I (IGF-I). The aim of our study was to investigate IGF-I levels in 33 postmenopausal patients with metastatic disease receiving the selective aromatase inhibitor 4-hydroxyandrostenedione: 250 mg (16 patients) or...
journal_title：Breast cancer research and treatment
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1007/BF00666055
更新日期：1994-01-01 00:00:00
abstract：:Number of mitoses and EGF binding were determined in parallel in biopsies of 27 lymph-node positive and of 23 lymph-node negative breast cancer patients. For node-positive patients the parameters for cell growth and EGF binding were quantitatively correlated by the equation y = P3 + P1(1- exp(- P2x]. For node-negative...
journal_title：Breast cancer research and treatment
pub_type： 杂志文章
doi：10.1007/BF01805739
更新日期：1988-09-01 00:00:00
