gms | German Medical Science

G-I-N Conference 2012

Guidelines International Network

22.08 - 25.08.2012, Berlin

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Effects of guideline adherent adjuvant treatment in primary breast cancer – A retrospective multi-center-cohort study of 3,976 patients

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  • L. Schwentner - University Ulm, Department of Gynecology and Obstetrics, Ulm, Germany
  • R. Wolters - University Bremen, Department of Mathematics and Computerscience, Bremen, Germany
  • M. Wischnewsky - University Bremen, Department of Mathematics and Computerscience, Bremen, Germany
  • R. Kreienberg - University Ulm, Department of Gynecology and Obstetrics, Ulm, Germany
  • A. Wöckel - University Ulm, Department of Gynecology and Obstetrics, Ulm, Germany

Guidelines International Network. G-I-N Conference 2012. Berlin, 22.-25.08.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocP175

doi: 10.3205/12gin287, urn:nbn:de:0183-12gin2874

Published: July 10, 2012

© 2012 Schwentner et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Background: The aim of that study was to analyze the impact of guideline adherent adjuvant treatment in early breast cancer on survival in a non-selected retrospective clinical cohort.

Methods: A retrospective multi-center cohort study called BRENDA (‘breast cancer under evidence based guidelines’) analyzed 3976 patients first diagnosed with primary breast. The classification of guideline adherent adjuvant treatment was based on the German national S3-guideline for diagnosis and treatment of breast cancer.

Results: There was a significant association between treatment adherence and prolonged recurrence free [p<0.001; HR=2.20 (95% CI: 1.74–2.79)] and overall survival [p<0.001; HR=2.57 (95% CI: 1.96–3.37)]. The greater the number of violations in guideline adherence, the lower was overall survival (p<0.0001). Advanced age at initial diagnosis was additionally associated with a reduction in guideline adherence. The percentage of guideline adherence for the therapeutic modalities BCT, mastectomy, axillary dissection and hormone therapy was greater than 80%. For chemotherapy, the percent of guideline adherence was 71.4%.

Conclusion: There is a strong association between guideline adherent adjuvant treatment and improved survival in primary breast cancer.