Ingrid A Woelfel1, Leopoldo J Fernandez1, Michael O Idowu2, Kazuaki Takabe3,4. 1. Division of Surgical Oncology, Department of Surgery, Virginia Commonwealth University Medical Center, Richmond, VA, USA. 2. Department of Pathology, Virginia Commonwealth University Medical Center, Richmond, VA, USA. 3. Breast Surgery, Department of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, NY, USA. 4. Department of Surgery, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, The State University of New York, Buffalo, NY, USA.
Abstract
BACKGROUND: Despite our most advanced medical and surgical treatment 40,000 women die from breast cancer each year. The aging population and their increasing burden of comorbidities may not be able to realize the full benefit of treatments due to a combination of the side effects and patient frailty. The aim of this study was to characterize the comorbidities of breast cancer patients and to determine if the number of comorbidities is a significant contributor to survival. METHODS: A database including patients from the year 2002 to 2012 was created to include health comorbidities from the electronic medical record. Patients were classified into groups according to their number of comorbidities. Disease free and overall survival was calculated for each patient. A one-way analysis of variance was then performed to determine if there was a difference in survival. RESULTS: A total of 279 patients were included: predominately African American (48.7%), female (98.6%) and late middle age (average age =56.1 years). The average number of comorbidities was 2.2 with hypertension and obesity being the most common. Significant differences were found in the number of comorbidities between African Americans (2.61) and Caucasians (1.78) (P<0.005). Disease free survival and overall survival according to number of comorbidities were both significantly different (F=2.775, P<0.008; F=3.684, P<0.001) with a threshold of decreased survival at six comorbidities. CONCLUSIONS: The population of women who face breast cancer is heterogeneous with a wide variety of comorbidities, which negatively impact their survival.
BACKGROUND: Despite our most advanced medical and surgical treatment 40,000 women die from breast cancer each year. The aging population and their increasing burden of comorbidities may not be able to realize the full benefit of treatments due to a combination of the side effects and patient frailty. The aim of this study was to characterize the comorbidities of breast cancer patients and to determine if the number of comorbidities is a significant contributor to survival. METHODS: A database including patients from the year 2002 to 2012 was created to include health comorbidities from the electronic medical record. Patients were classified into groups according to their number of comorbidities. Disease free and overall survival was calculated for each patient. A one-way analysis of variance was then performed to determine if there was a difference in survival. RESULTS: A total of 279 patients were included: predominately African American (48.7%), female (98.6%) and late middle age (average age =56.1 years). The average number of comorbidities was 2.2 with hypertension and obesity being the most common. Significant differences were found in the number of comorbidities between African Americans (2.61) and Caucasians (1.78) (P<0.005). Disease free survival and overall survival according to number of comorbidities were both significantly different (F=2.775, P<0.008; F=3.684, P<0.001) with a threshold of decreased survival at six comorbidities. CONCLUSIONS: The population of women who face breast cancer is heterogeneous with a wide variety of comorbidities, which negatively impact their survival.
Entities:
Keywords:
Breast cancer; comorbidities; depression; hypertension; obesity
Authors: M Clarke; R Collins; S Darby; C Davies; P Elphinstone; V Evans; J Godwin; R Gray; C Hicks; S James; E MacKinnon; P McGale; T McHugh; R Peto; C Taylor; Y Wang Journal: Lancet Date: 2005-12-17 Impact factor: 79.321
Authors: Nis P Suppli; Christoffer Johansen; Jane Christensen; Lars V Kessing; Niels Kroman; Susanne O Dalton Journal: J Clin Oncol Date: 2014-10-27 Impact factor: 44.544
Authors: Bernard Rosner; A Heather Eliassen; Adetunji T Toriola; Wendy Y Chen; Susan E Hankinson; Walter C Willett; Catherine S Berkey; Graham A Colditz Journal: Int J Cancer Date: 2017-05-01 Impact factor: 7.396
Authors: Hirofumi Saiki; Ivy A Petersen; Christopher G Scott; Kent R Bailey; Shannon M Dunlay; Randi R Finley; Kathryn J Ruddy; Elizabeth Yan; Margaret M Redfield Journal: Circulation Date: 2017-01-29 Impact factor: 29.690
Authors: Sungmin Park; Ho Hur; Ji Sung Lee; JaeSun Yoon; Sung Mo Hur; Il Yong Chung; Jong Won Lee; Hyun Jo Youn; Se Jeong Oh; Cheol Wan Lim; Jihyoun Lee Journal: J Breast Cancer Date: 2021-12 Impact factor: 3.588