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World J Clin Oncol. Dec 10, 2014; 5(5): 1088-1096
Published online Dec 10, 2014. doi: 10.5306/wjco.v5.i5.1088
Published online Dec 10, 2014. doi: 10.5306/wjco.v5.i5.1088
Competing risks of death in younger and older postmenopausal breast cancer patients
Judy-Anne W Chapman, NCIC Clinical Trials Group, Queen’s University, Kingston, ON, K7L 3N6, Canada
Kathleen I Pritchard, Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, M4N 3M5, Canada
Paul E Goss, Massachusetts General Hospital, Harvard University, Boston, MA 02114, United States
James N Ingle, Mayo Clinic, Rochester, MN 55902, United States
Hyman B Muss, Lineberger Comprehensive Cancer Center at the University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, United States
Susan F Dent, Ottawa Hospital Cancer Center, University of Ottawa, Ottawa, ON, K1H 8L6, Canada
Ted A Vandenberg, London Health Sciences Centre, University of Western Ontario, London, ON, N6G 2V4, Canada
Brian Findlay, Niagara Health System, McMaster University, St. Catharines, ON, L2R 2Z4, Canada
Karen A Gelmon, BC Cancer Agency, University of British Columbia, Vancouver, BC, V5Z 1L3, Canada
Carolyn F Wilson, Lois E Shepherd, NCIC Clinical Trials Group, Queen’s University, Kingston, Ontario, K7L 3N6, Canada
Michael N Pollak, Lady Davis Institute, Jewish General Hospital, McGill University, Montreal, QC, H3T 1E2, Canada
Author contributions: Chapman JAW designed the research; Goss PE, Ingle JN, Muss HB, Shepherd LE and Pollak MN contributed to conception; Pritchard KI, Goss PE, Dent SF, Vandenberg TA, Findlay B, Gelmon KA, Wilson CF, Shepherd LE and Pollak MN contributed to data; Chapman JAW analyzed the data; Chapman JAW drafted the article with critical content review and revision by all other authors; all authors approved the version submitted for publication.
Supported by the Canadian Cancer Society through a grant to the NCIC Clinical Trials Group from the Canadian Cancer Society Research Institute; Novartis provided the NCIC CTG MA.14 drug octreotide LAR
Correspondence to: Judy-Anne W Chapman, PhD, Senior Biostatistician, NCIC Clinical Trials Group, Queen’s University, 10 Stuart Street, Kingston, ON, K7L 3N6, Canada. jachapma@aol.com
Telephone: +1-613-5336430 Fax: +1-613-5332941
Received: December 22, 2013
Revised: April 30, 2014
Accepted: July 12, 2014
Published online: December 10, 2014
Processing time: 354 Days and 8 Hours
Revised: April 30, 2014
Accepted: July 12, 2014
Published online: December 10, 2014
Processing time: 354 Days and 8 Hours
Core Tip
Core tip: With earlier detection and improved therapies, patients with early breast cancer simultaneously face multiple health risks; 54% of women ≥ 70 years at diagnosis died from other causes. Octreotide LAR, an early drug targeting the insulin pathway, might have affected both breast and other cause mortality. We demonstrated a method of jointly assessing the impact of therapy and baseline patient characteristics on multiple causes of death. Older patients with higher body mass index experienced more other cause mortality, while women with smaller hormone receptor positive tumours and less lymph node involvement were less likely to die from breast cancer.