title: Adherence to Needed Adjuvant Therapy Could Decrease Recurrence Rates for Rural Patients With Early Breast Cancer.
abstract: The purpose of this study was to evaluate the differences in stage upon diagnosis, adherence to adjuvant treatment, and recurrence between rural and urban patients with early breast cancer.
  
  
  
  This retrospective study included 3640 patients with primary breast cancer recruited from 2000 to 2009. Patients who developed recurrence or metastasis were verified by adequate diagnostic imaging modalities and pathology. The χ2test was used to compare groups with respect to variables (recurrence and clinicopathologic features). A multivariable Cox proportional hazard regression model was used to estimate the hazard ratio (HR) and 95% confidence interval (CI) for breast cancer recurrence risk.
  
  
  
  Compared with tumors in urban patients, those in rural patients showed higher histologic grade, larger size, more lymphatic metastasis, and higher Ki-67 index; therapy adherence was strongly associated with recurrence in both. Compared with urban patients, the female rural patients had a higher recurrence rate. However, no significant difference in recurrence rates was observed between urban and rural patients following guideline adherence.
  
  
  
  The results of our study suggest that the later stage upon diagnosis and nonadherence to treatment contribute toward worse breast cancer outcomes among rural patients with breast cancer. Adherence to needed adjuvant therapy could decrease recurrence rates for rural patients with early breast cancer.
authors.affiliation: Department of Medical Oncology, The Tumor Hospital of Harbin Medical University, Harbin, China.
authors.forename: Qijia
authors.initials: Q
authors.lastname: Xuan
authors.affiliation: Department of Medical Oncology, The Tumor Hospital of Harbin Medical University, Harbin, China.
authors.forename: Kun
authors.initials: K
authors.lastname: Gao
authors.affiliation: Department of Medical Oncology, The Tumor Hospital of Harbin Medical University, Harbin, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Song
authors.affiliation: Department of Medical Oncology, The Tumor Hospital of Harbin Medical University, Harbin, China.
authors.forename: Shu
authors.initials: S
authors.lastname: Zhao
authors.affiliation: Department of Medical Oncology, The Tumor Hospital of Harbin Medical University, Harbin, China.
authors.forename: Lina
authors.initials: L
authors.lastname: Dong
authors.affiliation: Logistics University of People's Armed Police Force, Tianjin, China.
authors.forename: Zhongbai
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Department of Medical Oncology, The Tumor Hospital of Harbin Medical University, Harbin, China. Electronic address: zqyxsci@126.com.
authors.forename: Qingyuan
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: Department of Medical Oncology, The Tumor Hospital of Harbin Medical University, Harbin, China. Electronic address: wjxilywendy@126.com.
authors.forename: Jingxuan
authors.initials: J
authors.lastname: Wang
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy*; D002681:China / Q000453:epidemiology; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy*; D009367:Neoplasm Staging; D017410:Practice Guidelines as Topic; D011379:Prognosis; D012189:Retrospective Studies; D012423:Rural Health / Q000706:statistics & numerical data; D014504:Urban Health / Q000706:statistics & numerical data; D016903:Drug Monitoring
keywords: Adherence; Breast cancer; Recurrence rate; Rural; Urban