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- W2000430869 abstract "Purpose/Objective(s)To examine factors associated with outcome in a racially diverse cohort of women with early breast cancer.Materials/Methods1055 women with Stage I (70%) or II (30%) breast cancer treated with breast conservation therapy (BCT) between 1984–2004 were analyzed using competing risks methods for cumulative incidence of LRF (locoregional failure), distant failure (DF), and mortality as first events. Backward stepwise Cox proportional hazards models were used to identify factors prognostic for overall survival (OS), disease-free survival (DFS) and locoregional control (LRC). OS, DFS, and LRC were estimated using the Kaplan-Meier method. DFS time was defined as time to first LRF, DF, or death. The LRC definition censored deaths without LRF. Covariates for multivariate analysis (MVA) included age, weight, tumor size, node positive status, hormone receptor positive status, grade, chemotherapy use, margin status, black race, co-morbid diseases (CMD), and method of detection (clinical vs. mammographic). In the table, only covariates that reached statistical significance are shown.ResultsMedian follow-up was 81 months. Mean age was 60.8 years (range 40–91). 50% of the tumors were mammographically detected (Mdet). The mean size of Mdet tumors was 1.15 cm (black) vs. 1.18 cm (non-black) (p = .68). The 8-year (8Y) cumulative incidence (CI) of LRF was 3.9% for all patients (black-6.0%, non-black-3.2%, p = .069). The 8Y CI of DF was 5.1% (black-7.0%, non-black-4.4%, p = .47). The 8Y CI of intercurrent mortality was 10.6% (black-13.9%, non-black-9.4%, p = .007). 8Y DFS was 80.4% (black-73.1%, non-black-83.1%, p = .01). 8Y OS was 84.8% (black-80.1%, non-black 86.5%, p = .01).In the non-black population, Mdet was a favorable prognostic indicator for OS and DFS. However, in black patients, Mdet was not associated with improved OS or DFS in spite of virtually identical mean tumor size at detection (Table). MVA on the Mdet population revealed black race, node positive disease, co-morbid disease and increasing age to be statistically significantly associated with poor outcomes for OS (data not shown). Black race, CMD and increasing age were also statistically significantly associated with poor DFS. On analysis of patients with clinically detected tumors, race was not significant for OS (HR 1.05, 95% CI 0.67–1.65, p = .82) or DFS (HR 1.14, 95% CI 0.76–1.73, p = 0.52).ConclusionsTabled 1Overall survivalDisease free survivalMean sizeHR (95% CI)HR (95% CI)MdetCdetNon-black (NB)Mdet 0.53 (0.35–0.78)Mdet 0.68 (0.47–0.98)1.17 cm (All)1.83 cm (All)CMD 1.52 (1.02–2.27)CMD 1.44 (1.00–2.07)1.18 cm (NB)1.77 cm (NB)Inc. age 1.06 (1.04–1.08)Inc. age 1.04 (1.02–1.06)1.15 cm (B)1.85 cm (B)Inc. Wt 1.01 (1.00–1.02)p = 0.68p = .20Black (B)Inc. age 1.07 (1.03–1.07)Inc. age 1.05 (1.03–1.07) Open table in a new tab Purpose/Objective(s)To examine factors associated with outcome in a racially diverse cohort of women with early breast cancer. To examine factors associated with outcome in a racially diverse cohort of women with early breast cancer. Materials/Methods1055 women with Stage I (70%) or II (30%) breast cancer treated with breast conservation therapy (BCT) between 1984–2004 were analyzed using competing risks methods for cumulative incidence of LRF (locoregional failure), distant failure (DF), and mortality as first events. Backward stepwise Cox proportional hazards models were used to identify factors prognostic for overall survival (OS), disease-free survival (DFS) and locoregional control (LRC). OS, DFS, and LRC were estimated using the Kaplan-Meier method. DFS time was defined as time to first LRF, DF, or death. The LRC definition censored deaths without LRF. Covariates for multivariate analysis (MVA) included age, weight, tumor size, node positive status, hormone receptor positive status, grade, chemotherapy use, margin status, black race, co-morbid diseases (CMD), and method of detection (clinical vs. mammographic). In the table, only covariates that reached statistical significance are shown. 1055 women with Stage I (70%) or II (30%) breast cancer treated with breast conservation therapy (BCT) between 1984–2004 were analyzed using competing risks methods for cumulative incidence of LRF (locoregional failure), distant failure (DF), and mortality as first events. Backward stepwise Cox proportional hazards models were used to identify factors prognostic for overall survival (OS), disease-free survival (DFS) and locoregional control (LRC). OS, DFS, and LRC were estimated using the Kaplan-Meier method. DFS time was defined as time to first LRF, DF, or death. The LRC definition censored deaths without LRF. Covariates for multivariate analysis (MVA) included age, weight, tumor size, node positive status, hormone receptor positive status, grade, chemotherapy use, margin status, black race, co-morbid diseases (CMD), and method of detection (clinical vs. mammographic). In the table, only covariates that reached statistical significance are shown. ResultsMedian follow-up was 81 months. Mean age was 60.8 years (range 40–91). 50% of the tumors were mammographically detected (Mdet). The mean size of Mdet tumors was 1.15 cm (black) vs. 1.18 cm (non-black) (p = .68). The 8-year (8Y) cumulative incidence (CI) of LRF was 3.9% for all patients (black-6.0%, non-black-3.2%, p = .069). The 8Y CI of DF was 5.1% (black-7.0%, non-black-4.4%, p = .47). The 8Y CI of intercurrent mortality was 10.6% (black-13.9%, non-black-9.4%, p = .007). 8Y DFS was 80.4% (black-73.1%, non-black-83.1%, p = .01). 8Y OS was 84.8% (black-80.1%, non-black 86.5%, p = .01).In the non-black population, Mdet was a favorable prognostic indicator for OS and DFS. However, in black patients, Mdet was not associated with improved OS or DFS in spite of virtually identical mean tumor size at detection (Table). MVA on the Mdet population revealed black race, node positive disease, co-morbid disease and increasing age to be statistically significantly associated with poor outcomes for OS (data not shown). Black race, CMD and increasing age were also statistically significantly associated with poor DFS. On analysis of patients with clinically detected tumors, race was not significant for OS (HR 1.05, 95% CI 0.67–1.65, p = .82) or DFS (HR 1.14, 95% CI 0.76–1.73, p = 0.52). Median follow-up was 81 months. Mean age was 60.8 years (range 40–91). 50% of the tumors were mammographically detected (Mdet). The mean size of Mdet tumors was 1.15 cm (black) vs. 1.18 cm (non-black) (p = .68). The 8-year (8Y) cumulative incidence (CI) of LRF was 3.9% for all patients (black-6.0%, non-black-3.2%, p = .069). The 8Y CI of DF was 5.1% (black-7.0%, non-black-4.4%, p = .47). The 8Y CI of intercurrent mortality was 10.6% (black-13.9%, non-black-9.4%, p = .007). 8Y DFS was 80.4% (black-73.1%, non-black-83.1%, p = .01). 8Y OS was 84.8% (black-80.1%, non-black 86.5%, p = .01). In the non-black population, Mdet was a favorable prognostic indicator for OS and DFS. However, in black patients, Mdet was not associated with improved OS or DFS in spite of virtually identical mean tumor size at detection (Table). MVA on the Mdet population revealed black race, node positive disease, co-morbid disease and increasing age to be statistically significantly associated with poor outcomes for OS (data not shown). Black race, CMD and increasing age were also statistically significantly associated with poor DFS. On analysis of patients with clinically detected tumors, race was not significant for OS (HR 1.05, 95% CI 0.67–1.65, p = .82) or DFS (HR 1.14, 95% CI 0.76–1.73, p = 0.52). ConclusionsTabled 1Overall survivalDisease free survivalMean sizeHR (95% CI)HR (95% CI)MdetCdetNon-black (NB)Mdet 0.53 (0.35–0.78)Mdet 0.68 (0.47–0.98)1.17 cm (All)1.83 cm (All)CMD 1.52 (1.02–2.27)CMD 1.44 (1.00–2.07)1.18 cm (NB)1.77 cm (NB)Inc. age 1.06 (1.04–1.08)Inc. age 1.04 (1.02–1.06)1.15 cm (B)1.85 cm (B)Inc. Wt 1.01 (1.00–1.02)p = 0.68p = .20Black (B)Inc. age 1.07 (1.03–1.07)Inc. age 1.05 (1.03–1.07) Open table in a new tab" @default.
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- W2000430869 title "The Impact of Race and Mammographic Detection in Early Breast Cancer" @default.
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