D. Cronin-Fenton (Aarhus N, Denmark)
Aarhus University HospitalAuthor Of 2 Presentations
49P - Socioeconomic status and survivorship in premenopausal breast cancer patients: A population-based cohort study
Abstract
Background
Data on the influence of socioeconomic status (SES) on the effectiveness of cancer-directed treatment in premenopausal breast cancer patients is scarce.
Methods
From the Danish Breast Cancer Group (DBCG) clinical database, we assembled a cohort of all premenopausal women who were diagnosed with non-metastatic breast cancer and prescribed docetaxel-based chemotherapy during 2007–2011. The DBCG provided information on ER and HER-2 status, tumor size and lymph node status (to derive stage), histological grade, cancer-directed treatment, and recurrence. Danish population-based registries provided data on comorbidities, death, and SES at diagnosis (marital status, education, income, and employment). Follow-up began 6 months after diagnosis (to approximate the end of chemotherapy) and continued to 10 years, recurrence, death, or 31 December 2016, whichever occurred first. We computed incidence rates (IRs) per 1,000 person-years (PYs) and cumulative incidence proportions of recurrence and death. We used Poisson regression to calculate incidence rate ratios (IRRs) and 95% confidence intervals of recurrence and death according to SES, adjusting for patient, tumor, and treatment characteristics.
Results
Our cohort included 2,616 women; 286 developed recurrent breast cancer (13%, IR:18/1,000 PYs, median follow-up: 6.7 years) and 223 died (11%, IR:13/1,000 PYs, median follow-up: 7.2 years). As expected, women with ER‒ or triple negative tumors, higher stage and grade had elevated risk of recurrence and death. We observed increased risk of recurrence and death in unmarried women, mainly those with ER+ tumors prescribed tamoxifen. Women with ER+ tumors and health-related work absenteeism before diagnosis had increased mortality compared with their employed counterparts. Increased mortality in women with low SES, captured as low income or elementary school education, was explained by tumor characteristics.
Conclusions
Established prognostic characteristics were associated with recurrence and mortality in premenopausal women treated with docetaxel. Yet, we found unfavorable prognosis among unmarried women and women with health-related absenteeism from work; this may be partly related to tamoxifen adherence.
Legal entity responsible for the study
The study was approved by the Danish Data Protection Agency (AU 2016-051-000001, #808), the Regional Ethics Committee (Record no. 1-10-72-4-18) and the DBCG, the Danish Breast Cancer Group (DBCG-2019-08-20).
Funding
The Danish Cancer Society (R167-A11045-17-S2).
Disclosure
All authors have declared no conflicts of interest.
54P - Overweight and prognosis in triple-negative breast cancer patients: a systematic review and meta-analysis
Abstract
Background
The purpose is to conduct a systematic review and meta-analysis evaluating the impact of overweight on prognosis in triple-negative breast cancer (TNBC) patients.
Methods
Systematic searches were conducted in PubMed and Embase using variations of the search terms triple-negative breast neoplasms (population), overweight and/or obesity (exposure), and prognosis (outcome). Data were extracted from longitudinal observational studies, which used survival statistics with hazard ratios (HRs) to examine disease-free survival and/or overall survival according to body mass index measured at the time of diagnosis of TNBC. Overweight was defined using the World Health Organization guidelines. Guided by the Meta-analysis of Observational Studies in Epidemiology (MOOSE) checklist, study data were extracted and study quality assessed with the Newcastle-Ottawa Scale independently by two authors. The effect sizes (HRs) were combined with random-effects models, and the results were evaluated and adjusted for possible publication bias.
Results
The study selection process identified 11 eligible studies of 5,556 TNBC patients. The pooled estimates indicated that, relative to non-overweight, overweight was associated with both shorter disease-free survival (HR=1.33; 95%CI: 1.13–1.58) and shorter overall survival (HR=1.39; 95%CI: 1.15-1.69). Supplementary Bayesian meta-analyses showed strong evidence for non-zero effects, with the alternative hypothesis being 12.7 and 13.5 times more likely than the null-hypothesis for disease-free survival and overall survival, respectively.
Conclusions
Relative to non-overweight, overweight was associated with a shorter disease-free and overall survival among TNBC patients.
Legal entity responsible for the study
Aarhus University.
Funding
Slagtermester Max Wørzner og Hustru Wørzners Memorial Foundation, Health Research Foundation of Central Denmark Region, Aarhus University.
Disclosure
R. Zachariae: Honoraria (self), Shareholder/Stockholder/Stock options, None of this had any role in the design, data collection, analysis, or preparation of the manuscript: Novo Nordisk. S. Borgquist: Honoraria (self), Travel/Accommodation/Expenses, None of this had any role in the design, data collection, analysis, or preparation of the manuscript: Pfizer; Honoraria (self), Travel/Accommodation/Expenses, None of this had any role in the design, data collection, analysis, or preparation of the manuscript: Roche. All other authors have declared no conflicts of interest.