TY - JOUR
T1 - Risk factors and incidence of thromboembolic events (TEEs) in older men and women with breast cancer
AU - Chavez-MacGregor, M.
AU - Zhao, H.
AU - Kroll, M.
AU - Fang, S.
AU - Zhang, N.
AU - Hortobagyi, G. N.
AU - Buchholz, T. A.
AU - Shih, Y. C.
AU - Giordano, S. H.
N1 - Funding Information:
We used the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. The SEER program, supported by the USA National Cancer Institute (NCI), collects data from tumor registries; during the years included in this study, the database covered 14%–25% of the USA population. The Medicare program is administered by the Centers for Medicare and Medicaid Services and covers 97% of the USA population aged ‡65 years [16]. Of SEER participants who were diagnosed
PY - 2011/11
Y1 - 2011/11
N2 - Background: The purpose of this study is to evaluate the risk factors and the prevalence of thromboembolic events (TEEs) in breast cancer patients. Patients and methods: This is a retrospective cohort study using the Surveillance, Epidemiology, and End Results-Medicare database. Breast cancer patients diagnosed from 1992 to 2005 ‡66 years old were identified. International Classification of Diseases, Ninth Revision, and Healthcare Common Procedure Coding System codes were used to identify TEEs within 1 year of the breast cancer diagnosis. Analyses were conducted using descriptive statistics and logistic regression. Results: A total of 89 841 patients were included, of them 2658 (2.96%) developed a TEE. In the multivariable analysis, males had higher risk of a TEE than women [odd ratio (OR) = 1.57; confidence interval (CI) 1.10-2.25] and blacks had higher risk than whites (OR = 1.20; CI 1.04-1.40). Compared with stage I patients, patients with stage II, III and IV had 22%, 39% and 98% increase, respectively, in risk. Placement of central catheters (OR = 2.71; CI 2.43-3.02), chemotherapy treatment (OR = 1.66; CI 1.48-1.86) or treatment with erythropoiesis-stimulating agents (ESAs) (OR = 1.33; CI 1.33-1.52) increase the risk. Other significant predictors included comorbidities, age, receptor status, marital status and year of diagnosis. Similar estimates were seen for pulmonary embolism, deep vein thromboembolism and other TEEs. Conclusions: In total, 2.96% of patients in this cohort developed a TEE within 1 year from breast cancer diagnosis. Stage, gender, race, use of chemotherapy and ESAs, comorbidities, receptor status and catheter placement were associated with the development of TEEs.
AB - Background: The purpose of this study is to evaluate the risk factors and the prevalence of thromboembolic events (TEEs) in breast cancer patients. Patients and methods: This is a retrospective cohort study using the Surveillance, Epidemiology, and End Results-Medicare database. Breast cancer patients diagnosed from 1992 to 2005 ‡66 years old were identified. International Classification of Diseases, Ninth Revision, and Healthcare Common Procedure Coding System codes were used to identify TEEs within 1 year of the breast cancer diagnosis. Analyses were conducted using descriptive statistics and logistic regression. Results: A total of 89 841 patients were included, of them 2658 (2.96%) developed a TEE. In the multivariable analysis, males had higher risk of a TEE than women [odd ratio (OR) = 1.57; confidence interval (CI) 1.10-2.25] and blacks had higher risk than whites (OR = 1.20; CI 1.04-1.40). Compared with stage I patients, patients with stage II, III and IV had 22%, 39% and 98% increase, respectively, in risk. Placement of central catheters (OR = 2.71; CI 2.43-3.02), chemotherapy treatment (OR = 1.66; CI 1.48-1.86) or treatment with erythropoiesis-stimulating agents (ESAs) (OR = 1.33; CI 1.33-1.52) increase the risk. Other significant predictors included comorbidities, age, receptor status, marital status and year of diagnosis. Similar estimates were seen for pulmonary embolism, deep vein thromboembolism and other TEEs. Conclusions: In total, 2.96% of patients in this cohort developed a TEE within 1 year from breast cancer diagnosis. Stage, gender, race, use of chemotherapy and ESAs, comorbidities, receptor status and catheter placement were associated with the development of TEEs.
KW - Breast cancer
KW - Cancer-associated thrombosis
KW - Deep venous thrombosis
KW - Population-based study
KW - Thromboembolic events
KW - Thrombosis
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U2 - 10.1093/annonc/mdq777
DO - 10.1093/annonc/mdq777
M3 - Article
C2 - 21393379
AN - SCOPUS:80155178176
SN - 0923-7534
VL - 22
SP - 2394
EP - 2402
JO - Annals of Oncology
JF - Annals of Oncology
IS - 11
ER -