National Healthcare Quality and Disparities Report
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Search All Research Studies
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- Adverse Events (1)
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- (-) Cancer: Breast Cancer (16)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 16 of 16 Research Studies DisplayedKang MM, Hasan Y, Waller J
Has hypofractionated whole-breast radiation therapy become the standard of care in the United States? An updated report from National Cancer Database.
This study examined trends in the use of hypofractionated whole-breast irradiation (HF-WBI) over time in the United States and factors related to its adoption for patients undergoing a lumpectomy from 2004 to 2016. Lumpectomy patients in the National Cancer Database were identified, with 688,079 early-stage invasive breast cancer patients, and 248,218 patients diagnosed with ductal carcinoma in situ. Among invasive cancer patients, HB-WBI use increased from 0.7% in 2004 to 38.1% in 2016. Among ductal carcinoma in situ patients, HB-WBI use increased significantly from 0.42% in 2004 to 34.3% in 2016. Factors associated with HB-WBI use included age, geographic location, race/ethnicity, tumor stage, grade, treating facility type, and volume.
AHRQ-funded; HS025806.
Citation: Kang MM, Hasan Y, Waller J .
Has hypofractionated whole-breast radiation therapy become the standard of care in the United States? An updated report from National Cancer Database.
Clin Breast Cancer 2022 Jan;22(1):e8-e20. doi: 10.1016/j.clbc.2021.05.016..
Keywords: Cancer: Breast Cancer, Cancer, Treatments, Practice Patterns
Dinan MA, Wilson LE, Reed SD
Association of 21-gene assay (OncotypeDX) testing and receipt of chemotherapy in the Medicare breast cancer patient population following initial adoption.
This study looked at trends in the association of 21-gene assay testing and receipt of chemotherapy in the Medicare breast cancer patient population following initial adoption from 2001 to 2011. The investigators looked at updated SEER-Medicare data from 2004 and 2011. The cohort included 26,009 patients who met inclusion criteria. Assay use was associated with a decrease in absolute percentage use of chemotherapy by 4.5%, which became even more pronounced from 2008-2011 with a decrease of 6.8%.
AHRQ-funded; HS022189.
Citation: Dinan MA, Wilson LE, Reed SD .
Association of 21-gene assay (OncotypeDX) testing and receipt of chemotherapy in the Medicare breast cancer patient population following initial adoption.
Clin Breast Cancer 2020 Dec;20(6):487-94.e1. doi: 10.1016/j.clbc.2020.05.010..
Keywords: Cancer: Breast Cancer, Cancer, Treatments, Genetics, Medicare, Women, Healthcare Utilization
Dinan MA, Wilson LE, Reed SD
Chemotherapy costs and 21-gene recurrence score genomic testing among Medicare beneficiaries with early-stage breast cancer, 2005 to 2011.
This study examined whether associations between 21-gene recurrence score (RS) genomic testing and lower costs among patients with early-stage, estrogen receptor-positive breast cancer were observable in real-world data from the Medicare population. The investigators found that RS testing was associated with lower overall and chemotherapy-related costs in patients with high-risk disease, consistent with lower chemotherapy use among these patients. Higher overall costs for patients with intermediate-risk and low-risk disease were driven largely by non-treatment-related costs.
AHRQ-funded; HS022189.
Citation: Dinan MA, Wilson LE, Reed SD .
Chemotherapy costs and 21-gene recurrence score genomic testing among Medicare beneficiaries with early-stage breast cancer, 2005 to 2011.
J Natl Compr Canc Netw 2019 Mar;17(3):245-54. doi: 10.6004/jnccn.2018.7097..
Keywords: Cancer, Cancer: Breast Cancer, Treatments, Genetics, Healthcare Costs, Medicare, Women
Wang SY, Kelly G, Gross C
Information needs of older women with early-stage breast cancer when making radiation therapy decisions.
The researchers identified the information older women with early-stage breast cancer need when making radiation therapy decisions, and who patients identify as the main decision maker. They found that older women consider themselves to be the main decision maker; they desire information and have more agency and input in the decision-making process than prior literature would suggest.
AHRQ-funded; HS023900.
Citation: Wang SY, Kelly G, Gross C .
Information needs of older women with early-stage breast cancer when making radiation therapy decisions.
Int J Radiat Oncol Biol Phys 2017 Jul 15;98(4):733-40. doi: 10.1016/j.ijrobp.2017.02.001.
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Keywords: Cancer: Breast Cancer, Shared Decision Making, Education: Patient and Caregiver, Treatments
Taylor C, Correa C, Duane FK
Estimating the risks of breast cancer radiotherapy: evidence from modern radiation doses to the lungs and heart and from previous randomized trials.
The researchers estimated the absolute long-term risks of modern breast cancer radiotherapy. They concluded that, for long-term smokers, the absolute risks of modern radiotherapy may outweigh the benefits, yet for most nonsmokers (and ex-smokers), the benefits of radiotherapy far outweigh the risks. Hence, smoking can determine the net effect of radiotherapy on mortality, but smoking cessation substantially reduces radiotherapy risk.
AHRQ-funded; HS021681.
Citation: Taylor C, Correa C, Duane FK .
Estimating the risks of breast cancer radiotherapy: evidence from modern radiation doses to the lungs and heart and from previous randomized trials.
J Clin Oncol 2017 May 20;35(15):1641-49. doi: 10.1200/jco.2016.72.0722.
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Keywords: Adverse Events, Cancer: Breast Cancer, Risk, Treatments
Giordano SH, Niu J, Chavez-MacGregor M
Estimating regimen-specific costs of chemotherapy for breast cancer: observational cohort study.
The objective of the current study was to generate cost estimates for guideline-concordant adjuvant chemotherapy regimens from payers' and patients' perspectives in a large, insured US population. It concluded that the costs of breast cancer chemotherapy vary widely across regimens, and patients bear a substantial out-of-pocket burden.
AHRQ-funded; HS020263.
Citation: Giordano SH, Niu J, Chavez-MacGregor M .
Estimating regimen-specific costs of chemotherapy for breast cancer: observational cohort study.
Cancer 2016 Nov 15; 122(2):3447-3455. doi: 10.1002/cncr.30274.
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Keywords: Cancer, Cancer: Breast Cancer, Treatments, Healthcare Costs
Farias AJ, Du XL
Ethnic differences in initiation and timing of adjuvant endocrine therapy among older women with hormone receptor-positive breast cancer enrolled in Medicare Part D.
The aim of this study was to determine whether there are racial/ethnic differences in initiation and timing of adjuvant endocrine therapy (AET) after Medicare Part D drug coverage. After controlling for all variables, only Asian women were found to have a greater odds of initiation of overall AET compared to non-Hispanic white women. Hispanic Mexicans and non-Hispanic black patients had a significantly lower odds of tamoxifen initiation.
AHRQ-funded; HS018956.
Citation: Farias AJ, Du XL .
Ethnic differences in initiation and timing of adjuvant endocrine therapy among older women with hormone receptor-positive breast cancer enrolled in Medicare Part D.
Med Oncol 2016 Feb;33(2):19. doi: 10.1007/s12032-016-0732-1.
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Keywords: Cancer: Breast Cancer, Treatments, Patient-Centered Outcomes Research, Racial and Ethnic Minorities
Roberts MC, Weinberger M, Dusetzina SB
Racial variation in the uptake of oncotype DX testing for early-stage breast cancer.
Oncotype DX (ODX) has the potential to improve quality of care; however, if not equally accessible across racial groups, disparities in cancer care quality may persist or worsen. The researchers examined racial disparities in ODX testing uptake. They did not find racial disparities in ODX testing for node-negative patients for whom ODX testing is guideline recommended and widely covered by insurers.
HS019468; HS022189
Citation: Roberts MC, Weinberger M, Dusetzina SB .
Racial variation in the uptake of oncotype DX testing for early-stage breast cancer.
J Clin Oncol 2016 Jan 10;34(2):130-8. doi: 10.1200/jco.2015.63.2489..
Keywords: Cancer: Breast Cancer, Healthcare Delivery, Treatments, Disparities, Racial and Ethnic Minorities
Roberts MC, Bryson A, Weinberger M
Oncologists' barriers and facilitators for oncotype DX use: qualitative study.
The purpose of this paper was to understand better the U.S. oncologists' oncotype DX (ODX) uptake and how they use ODX during adjuvant chemotherapy decision making. This study identified multi-level factors that influence ODX uptake, including organizational factors, interpersonal factors, and intrapersonal factors.
AHRQ-funded; HS022189.
Citation: Roberts MC, Bryson A, Weinberger M .
Oncologists' barriers and facilitators for oncotype DX use: qualitative study.
Int J Technol Assess Health Care 2016 Jan;32(5):355-61. doi: 10.1017/s026646231600060x.
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Keywords: Cancer: Breast Cancer, Treatments, Shared Decision Making, Genetics, Medication
Lairson DR, Parikh RC, Cormier JN
Cost-effectiveness of chemotherapy for breast cancer and age effect in older women.
The researchers assessed the cost-effectiveness of chemotherapy regimens by age and disease stage under "real-world" conditions for patients with breast cancer. They found that anthracycline-based chemotherapy was found cost-effective for elderly patients with early stage (stage I, II, IIIa) breast cancer considering the US threshold of $100,000 per QALY.
AHRQ-funded; HS018956.
Citation: Lairson DR, Parikh RC, Cormier JN .
Cost-effectiveness of chemotherapy for breast cancer and age effect in older women.
Value Health 2015 Dec;18(8):1070-8. doi: 10.1016/j.jval.2015.08.008..
Keywords: Cancer: Breast Cancer, Treatments, Healthcare Costs, Elderly, Social Determinants of Health
Potosky AL, O'Neill SC, Isaacs C
Population-based study of the effect of gene expression profiling on adjuvant chemotherapy use in breast cancer patients under the age of 65 years.
The authors evaluated the relation between gene expression profiling (GEP) testing and the use of adjuvant chemotherapy by women treated in a general oncology practice. They found that adjuvant chemotherapy use after GEP testing is generally consistent with the recommended test interpretation for women with a high or low predicted risk of recurrence. Chemotherapy use in the intermediate-risk group increased with Recurrence Score values, and evidence from ongoing randomized trials may help to clarify whether this finding reflects optimal interpretation of GEP test results.
AHRQ-funded; HS022915.
Citation: Potosky AL, O'Neill SC, Isaacs C .
Population-based study of the effect of gene expression profiling on adjuvant chemotherapy use in breast cancer patients under the age of 65 years.
Cancer 2015 Nov 15;121(22):4062-70. doi: 10.1002/cncr.29621.
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Keywords: Cancer, Cancer: Breast Cancer, Treatments, Shared Decision Making, Genetics, Practice Patterns, Women
Dinan MA, Mi X, Reed SD
Association between use of the 21-gene recurrence score assay and receipt of chemotherapy among Medicare beneficiaries with early-stage breast cancer, 2005-2009.
The researchers examined whether adoption of the 21-Gene Recurrence Score (RS) assay in a nationally representative sample of patients with early-stage breast cancer was associated with use of chemotherapy. They found that the impact of the adoption of the RS assay on receipt of chemotherapy was strongly population dependent and was associated with relatively lower chemotherapy use in groups with high-risk disease and relatively higher chemotherapy use in patients with low-risk disease.
AHRQ-funded; HS022189.
Citation: Dinan MA, Mi X, Reed SD .
Association between use of the 21-gene recurrence score assay and receipt of chemotherapy among Medicare beneficiaries with early-stage breast cancer, 2005-2009.
JAMA Oncol 2015 Nov 1;1(8):1098-109. doi: 10.1001/jamaoncol.2015.2722..
Keywords: Cancer, Cancer: Breast Cancer, Treatments, Genetics, Medicare, Women
Du XL, Zhang Y, Parikh RC
Comparative effectiveness of chemotherapy regimens in prolonging survival for two large population-based cohorts of elderly adults with breast and colon cancer in 1992-2009.
The purpose of this study was to compare the effectiveness of chemotherapy in prolonging survival according to age in breast and colon cancer. It found that the effectiveness of chemotherapy decreased with age in participants with breast cancer, in whom chemotherapy appears to be effective until age 79 except for the doxorubicin-cyclophosphamide combination, which was effective in participants aged 80 to 84.
AHRQ-funded; HS018956.
Citation: Du XL, Zhang Y, Parikh RC .
Comparative effectiveness of chemotherapy regimens in prolonging survival for two large population-based cohorts of elderly adults with breast and colon cancer in 1992-2009.
J Am Geriatr Soc 2015 Aug;63(8):1570-82. doi: 10.1111/jgs.13523..
Keywords: Cancer, Cancer: Breast Cancer, Treatments, Comparative Effectiveness, Patient-Centered Outcomes Research
Roberts MC, Weinberger M, Dusetzina SB
Racial variation in adjuvant chemotherapy initiation among breast cancer patients receiving oncotype DX testing.
The researchers examined whether adjuvant chemotherapy initiation varied by race. No racial differences were found in adjuvant chemotherapy initiation among women receiving ODX testing. As treatment decision-making becomes increasingly targeted with the use of genetic technologies, these results provide evidence that test results may drive treatment in a similar way across racial subgroups.
AHRQ-funded; HS022189.
Citation: Roberts MC, Weinberger M, Dusetzina SB .
Racial variation in adjuvant chemotherapy initiation among breast cancer patients receiving oncotype DX testing.
Breast Cancer Res Treat 2015 Aug;153(1):191-200. doi: 10.1007/s10549-015-3518-9..
Keywords: Cancer: Breast Cancer, Treatments, Shared Decision Making, Genetics, Racial and Ethnic Minorities
Kadakia A, Rajan SS, Abughosh S
CMF-regimen preferred as first-course chemotherapy for older and sicker women with breast cancer: findings from a SEER-Medicare-based population study.
This study aimed to determine the utilization of Cyclophosphamide, Methotrexate, and 5-Fluorouracil (CMF) as first-course chemotherapy in recent years, and identify the sociodemographic and clinical characteristics associated with its prescription. It found that older and sicker women, living in census tracts with lower average education, and diagnosed with advanced stage, hormone receptor-negative tumors have a higher probability of CMF administration.
AHRQ-funded; HS018956.
Citation: Kadakia A, Rajan SS, Abughosh S .
CMF-regimen preferred as first-course chemotherapy for older and sicker women with breast cancer: findings from a SEER-Medicare-based population study.
Am J Clin Oncol 2015 Apr;38(2):165-73. doi: 10.1097/COC.0b013e31828f5b01..
Keywords: Cancer: Breast Cancer, Treatments, Elderly, Social Determinants of Health
Pan IW, Smith BD, Shih YC
Factors contributing to underuse of radiation among younger women with breast cancer.
This study explores factors associated with noncompliance of RT among insured young patients. It found that competing demands from child care, especially the presence of a young child in the home, can constitute a barrier to complete guideline-concordant breast cancer therapy.
AHRQ-funded; HS018535.
Citation: Pan IW, Smith BD, Shih YC .
Factors contributing to underuse of radiation among younger women with breast cancer.
J Natl Cancer Inst 2014 Jan;106(1):djt340. doi: 10.1093/jnci/djt340..
Keywords: Cancer: Breast Cancer, Health Insurance, Patient Adherence/Compliance, Surgery, Treatments