Patterns of treatment for early stage breast cancers at the M. D. Anderson Cancer Center from 1997 to 2004.
BACKGROUND
The objectives of this study were to examine the patterns of use for adjuvant therapy and the changes in surgical practice for patients with early stage breast cancer and to describe how recent large clinical trial results impacted the patterns of care at The University of Texas M. D. Anderson Cancer Center (MDACC).


METHODS
The study included 5486 women who were diagnosed with stage I through IIIA breast cancer between 1997 and 2004 and received their treatment at MDACC. A chi-square trend test and multivariate logistic regression model were used to assess changes in treatment patterns over time.


RESULTS
Among lymph node-positive patients, the use of anthracycline plus taxane chemotherapy increased from 17% in 1997 to 81% in 2004 (P < .001). Meanwhile, the use of anthracyclines without taxanes dropped from 76% to 20% (P < .001) between 1997 and 2000. For postmenopausal patients who received endocrine therapy, the use of tamoxifen was replaced increasingly by the use of aromatase inhibitors (from 100% on tamoxifen in 1997 to 14% in 2004; P < .001). The percentage of women who underwent initial sentinel lymph node biopsy increased significantly during the period from 1997 to 2004 (from 1.8% to 69.7%, respectively, among patients who underwent mastectomy; and from 18.1% to 87.1%, respectively, among patients who underwent breast-conserving surgery; P < .001).


CONCLUSIONS
The results from this study suggested that key findings from adjuvant therapy and surgical procedures from large clinical trials often prompt immediate changes in the patient care practices of research hospitals like MDACC.
Shen
Yu
Y
Department of Biostatistics, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA. yshen@mdanderson.org
Dong
Wenli
W
Feig
Barry W
BW
Ravdin
Peter
P
Theriault
Richard L
RL
Giordano
Sharon H
SH
D000368:Aged; D018943:Anthracyclines / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D047072:Aromatase Inhibitors / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000601:surgery / Q000628:therapy*; D001952:Bridged-Ring Compounds / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D002986:Clinical Trials as Topic; D055088:Early Detection of Cancer; D004965:Estrogen Antagonists / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D013629:Tamoxifen / Q000627:therapeutic use; D043823:Taxoids / Q000627:therapeutic use; D013997:Time Factors
D018943:Anthracyclines; D047072:Aromatase Inhibitors; D001952:Bridged-Ring Compounds; D004965:Estrogen Antagonists; D043823:Taxoids; D013629:Tamoxifen; C080625:taxane