NEDenise-- don't know whether you should show this to the insurance company of not

[Lani]

But of course you are cured and they don't need to think about such things as facts and statistics

They will probably try to twist it ...but it is good news overall

Stage IVs live longer than they used to.

It is only an abstract for upcoming ASCO 2013 so I don't know why her2+ivity
was not mentioned--ie was it tested for and documented in the SEER registry (sort of doubt it)


Is the proportion of patients with synchronous stage IV breast cancer surviving > 2 years increasing over time?

Sub-category:
ER+

Category:
Breast Cancer - HER2/ER

Meeting:
2013 ASCO Annual Meeting

Abstract No:
524

Citation:
J Clin Oncol 31, 2013 (suppl; abstr 524)

Publication-only abstracts (abstract number preceded by an "e"), published in conjunction with the 2013 Annual Meeting but not presented at the Meeting, can be found online only.

Author(s): Shaheenah S. Dawood, Benjamin Haaland, Constance T. Albarracin, Ana M. Gonzalez-Angulo, Sudeep Gupta, Javier Cortes, Yoon Sim Yap, Rebecca Dent; Dubai Hospital, Dubai, United Arab Emirates; Duke-National University of Singapore Graduate Medical School, Singapore, Singapore; The University of Texas MD Anderson Cancer Center, Houston, TX; Tata Memorial Centre, Mumbai, India; Vall d'Hebron University Hospital, Barcelona, Spain; National Cancer Centre Singapore, Singapore, Singapore; National Cancer Center Singapore, Duke-National University Singapore, Singapore, Singapore

Abstract Disclosures


Abstract:

Background: Studies have shown a moderate increase in survival over time among pts with stageIV breast cancer. Median survival is approximately 2 yrs. The aim of this study was to evaluate trends over time of pts with synchronous stage IV disease who survive >2 yrs. Methods: Using the SEER registry we identified female pts with synchronous stage IV breast cancer diagnosed between 1990-2007. Pts were divided into 3 groups according to year of diagnosis(1990-1995, 1996-2000, 2001-2007). Probability of surviving more than >2 yrs was computed within each group. A multivariable logistic regression model was then fitted to determine the association between year of diagnosis and the probability of surviving >2 yrs after adjusting for other prognostic factors. Results: 22,492 pts were identified of whom 9,388 (41.7%) had a survival of >2 yrs. The probability of surviving >2 yrs was 36.2%, 40.1%, and 44.2% among pts diagnosed in periods 1990-1995, 1996-2000, and 2001-2007 respectively (p-value < 0.0001). The probability of surviving >2 yrs was 55.3% and 29.3% among pts with ER+ and ER- disease respectively (p-value <0.0001) and was 32.9% and 43.5% among pts of black and white race respectively (p-value <0.0001). In the multivariable model the probability of surviving >2 yrs increased with increasing year of diagnosis (OR 1.04, 95% CI 1.03-1.05, p <0.0001). Other factors significantly associated with an increased probability of surviving >2 yrs included radiation therapy, lower grade, younger age, hormone receptor (HR) positive disease and non-inflammatory disease. Interaction term between race and year of diagnosis was marginally significant, such that black pts had a more slowly increasing probability of surviving >2 yrs compared to whites (OR 0.97, 95% CI 0.96-1.00, p = 0.037). Interaction term between HR status and year of diagnosis was not significant. Conclusions: Our results indicate that among pts with synchronous stage IV breast cancer the probability of surviving >2 yrs has increased over time reflecting the introduction and FDA approval of multiple efficacious chemotherapeutic and endocrine therapeutic options. Of concern, the probability of surviving >2 yrs has increased more slowly among pts of black race.

[NEDenise]

Lani,
Hmmm...when I read this...I responded...or at least I typed a response. I guess I forgot to click on "post"...Duh! Brain tumor! You have to forgive me!

So...no, I definitely won't be forwarding this to the insurance wonks. Not that they'd read it anyway. But I enjoyed reading it. You see, I've always prided myself on being an overachiever. So that median thing...well that's more like my baseline! And, if I'm reading things correctly...never a sure thing with these articles...my 2 year clock doesn't start ticking until the mets were diagnosed. So, I'm not even one year into that yet.

I'm not HR+...so that sucks. But my BC isn't inflammatory..so that's good. And, as always...being HER2+ is a blessing in disguise!

And, as for my insurance company...terminal is terminal. PERIOD. End of discussion. Their crystal ball isn't any more accurate than my doctor's. And the federal government is on my side too. So...they can drag their feet a little...but I'm confident that in the end, I'll win. Then, I can take my sweet old time spending the money to which I am so richly entitled. With luck, as a veteran overachiever...I'll outlive the median, and the standard deviation...maybe even become the outlier at the upper limit!

Thanks, Lani
You're a gem!
Denise