| Title |
Frailty and long-term mortality of older breast cancer patients: CALGB 369901 (Alliance)
|
|---|---|
| Published in |
Breast Cancer Research and Treatment, March 2017
|
| DOI | 10.1007/s10549-017-4222-8 |
| Pubmed ID | |
| Authors |
Jeanne S. Mandelblatt, Ling Cai, George Luta, Gretchen Kimmick, Jonathan Clapp, Claudine Isaacs, Brandeyln Pitcher, William Barry, Eric Winer, Stephen Sugarman, Clifford Hudis, Hyman Muss, Harvey J. Cohen, Arti Hurria |
| Abstract |
Breast cancer patients aged 65+ ("older") vary in frailty status. We tested whether a deficits accumulation frailty index predicted long-term mortality. Older patients (n = 1280) with non-metastatic, invasive breast cancer were recruited from 78 Alliance sites from 2004 to 2011, with follow-up to 2015. Frailty categories (robust, pre-frail, and frail) were based on 35 baseline illness and function items. Cox proportional hazards and competing risk models were used to calculate all-cause and breast cancer-specific mortality for up to 7 years, respectively. Potential covariates included demographic, psychosocial, and clinical factors, diagnosis year, and care setting. Patients were 65-91 years old. Most (76.6%) were robust; 18.3% were pre-frail, and 5.1% frail. Robust patients tended to receive more chemotherapy ± hormonal therapy (vs. hormonal) than pre-frail or frail patients (45% vs. 37 and 36%, p = 0.06), and had the highest adherence to hormonal therapy. The adjusted hazard ratios for all-cause mortality (n = 209 deaths) were 1.7 (95% CI 1.2-2.4) and 2.4 (95% CI 1.5-4.0) for pre-frail and frail versus robust women, respectively, with an absolute mortality difference of 23.5%. The adjusted hazard of breast cancer death (n-99) was 3.1 (95% CI 1.6-5.8) times higher for frail versus robust patients (absolute difference of 14%). Treatment differences did not account for the relationships between frailty and mortality. Most older breast cancer patients are robust and could consider chemotherapy where otherwise indicated. Patients who are frail or pre-frail have elevated long-term all-cause and breast cancer mortality. Frailty indices could be useful for treatment decision-making and care planning with older patients. |
X Demographics
The data shown below were collected from the profiles of 7 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 2 | 29% |
| Ireland | 1 | 14% |
| Brazil | 1 | 14% |
| Unknown | 3 | 43% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 3 | 43% |
| Scientists | 2 | 29% |
| Practitioners (doctors, other healthcare professionals) | 2 | 29% |
Mendeley readers
The data shown below were compiled from readership statistics for 49 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 49 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 6 | 12% |
| Student > Doctoral Student | 6 | 12% |
| Student > Master | 5 | 10% |
| Student > Bachelor | 4 | 8% |
| Other | 4 | 8% |
| Other | 11 | 22% |
| Unknown | 13 | 27% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 16 | 33% |
| Social Sciences | 4 | 8% |
| Nursing and Health Professions | 3 | 6% |
| Psychology | 3 | 6% |
| Sports and Recreations | 2 | 4% |
| Other | 5 | 10% |
| Unknown | 16 | 33% |
Attention Score in Context
This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 16 June 2017.
All research outputs
#7,624,220
of 25,000,733 outputs
Outputs from Breast Cancer Research and Treatment
#1,632
of 4,939 outputs
Outputs of similar age
#112,065
of 314,855 outputs
Outputs of similar age from Breast Cancer Research and Treatment
#26
of 99 outputs
Altmetric has tracked 25,000,733 research outputs across all sources so far. This one has received more attention than most of these and is in the 69th percentile.
So far Altmetric has tracked 4,939 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 7.3. This one has gotten more attention than average, scoring higher than 66% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 314,855 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 63% of its contemporaries.
We're also able to compare this research output to 99 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 74% of its contemporaries.