| Title |
Guidelines are advantageous, though not essential for improved survival among breast cancer patients
|
|---|---|
| Published in |
Breast Cancer Research and Treatment, June 2015
|
| DOI | 10.1007/s10549-015-3484-2 |
| Pubmed ID | |
| Authors |
Regine Wolters, Jörg Wischhusen, Tanja Stüber, Claire Rachel Weiss, Mathias Krockberger, Catharina Bartmann, Maria Blettner, Wolfgang Janni, Rolf Kreienberg, Lukas Schwentner, Igor Novopashenny, Manfred Wischnewsky, Achim Wöckel, Joachim Diessner |
| Abstract |
The purpose of this retrospective multicenter study was to resolve the pseudo-paradox that the clinical outcome of women affected by breast cancer has improved during the last 20 years irrespective of whether they were treated in accordance with clinical guidelines or not. This retrospective German multicenter study included 9061 patients with primary breast cancer recruited from 1991 to 2009. We formed subgroups for the time intervals 1991-2000 (TI1) and 2001-2009 (TI2). In these subgroups, the risk of recurrence (RFS) and overall survival (OS) were compared between patients whose treatment was either 100 % guideline-conforming or, respectively, non-guideline-conforming. The clinical outcome of all patients significantly improved in TI2 compared to TI1 [RFS: p < 0.001, HR = 0.57, 95 % CI (0.49-0.67); OS: p < 0.001, HR = 0.76, 95 % (CI 0.66-0.87)]. OS and RFS of guideline non-adherent patients also improved in TI2 compared to TI. Comparing risk profiles, determined by Nottingham Prognostic Score reveals a significant (p = 0.001) enhancement in the time cohort TI2. Furthermore, the percentage of guideline-conforming systemic therapy (endocrine therapy and chemotherapy) significantly increased (p < 0.001) in the time cohort TI2 to TI for the non-adherent group. The general improvement of clinical outcome of patients during the last 20 years is also valid in the subgroup of women who received treatments, which deviated from the guidelines. The shift in risk profiles as well as medical advances are major reasons for this improvement. Nevertheless, patients with 100 % guideline-conforming therapy always had a better outcome compared to patients with guideline non-adherent therapy. |
Mendeley readers
The data shown below were compiled from readership statistics for 17 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 17 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Lecturer | 3 | 18% |
| Student > Master | 3 | 18% |
| Researcher | 3 | 18% |
| Student > Doctoral Student | 2 | 12% |
| Student > Bachelor | 1 | 6% |
| Other | 3 | 18% |
| Unknown | 2 | 12% |
| Readers by discipline | Count | As % |
|---|---|---|
| Nursing and Health Professions | 3 | 18% |
| Agricultural and Biological Sciences | 2 | 12% |
| Medicine and Dentistry | 2 | 12% |
| Biochemistry, Genetics and Molecular Biology | 1 | 6% |
| Pharmacology, Toxicology and Pharmaceutical Science | 1 | 6% |
| Other | 4 | 24% |
| Unknown | 4 | 24% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. 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 06 August 2015.
All research outputs
#20,290,425
of 22,826,360 outputs
Outputs from Breast Cancer Research and Treatment
#4,109
of 4,659 outputs
Outputs of similar age
#219,969
of 263,990 outputs
Outputs of similar age from Breast Cancer Research and Treatment
#60
of 78 outputs
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We're also able to compare this research output to 78 others from the same source and published within six weeks on either side of this one. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.