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Impact of deviation from guideline recommended treatment on breast cancer survival in Asia
- Source :
- Scientific Reports, Vol 10, Iss 1, Pp 1-12 (2020), Scientific Reports
- Publication Year :
- 2020
- Publisher :
- Springer Science and Business Media LLC, 2020.
-
Abstract
- Breast cancer survival has improved with significant progress in treatment and disease management. However, compliance with treatment varies. Treatment guidelines for older patients are unclear. We aim to identify predictors of noncompliance with recommended therapy in a large breast cancer population and assess the impact of noncompliance on survival. Our study included 19,241 non-metastatic female breast cancer patients, of whom 3,158 (16%) died within 10 years post-diagnosis (median survival = 5.8 years). We studied the association between treatment noncompliance and factors with logistic regression, and the impact of treatment noncompliance on survival with a flexible parametric survival model framework. The highest proportion of noncompliance was observed for chemotherapy (18%). Predictors of noncompliance with chemotherapy, radiotherapy and endocrine therapy included age, tumor size, nodal involvement and subtype (except radiotherapy). Factors associated with not receiving surgery included age and subtype. Treatment noncompliance was associated with worse overall survival for surgery (HR: 2.26 [1.80–2.83]), chemotherapy (1.25 [1.11–1.41]), radiotherapy (2.28 [1.94–2.69]) and endocrine therapy (1.70 [1.41–2.04]). Worse survival was similarly observed in older patients for whom guidelines generally do not apply. Our results highlight the importance of following appropriate treatment as recommended by current guidelines. Older patients may benefit from similar recommendations.
- Subjects :
- Adult
medicine.medical_specialty
Asia
Epidemiology
medicine.medical_treatment
Population
lcsh:Medicine
Breast Neoplasms
Logistic regression
Article
03 medical and health sciences
0302 clinical medicine
Breast cancer
Internal medicine
medicine
Humans
Registries
030212 general & internal medicine
lcsh:Science
education
Survival analysis
Aged
Aged, 80 and over
education.field_of_study
Chemotherapy
Multidisciplinary
business.industry
lcsh:R
Disease Management
Cancer
Guideline
Middle Aged
medicine.disease
Combined Modality Therapy
Radiation therapy
Risk factors
030220 oncology & carcinogenesis
Practice Guidelines as Topic
Female
lcsh:Q
Guideline Adherence
business
Subjects
Details
- ISSN :
- 20452322
- Volume :
- 10
- Database :
- OpenAIRE
- Journal :
- Scientific Reports
- Accession number :
- edsair.doi.dedup.....3bab1d3789648b379439874abaaa4709