Comorbidities and Their Management: Potential Impact on Breast Cancer Outcomes
Comorbidities and Their Management: Potential Impact on Breast Cancer Outcomes
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DOI：
10.1007/978-3-319-16366-6_11
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发表时间：
2015-01-01
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影响因子：
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通讯作者：
Goodwin, Pamela J.
中科院分区：
文献类型：
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作者：
Hong, Chi-Chen;Ambrosone, Christine B.;Goodwin, Pamela J.
预先存在的合并症对整体乳腺癌预后产生负面影响，增加乳腺癌特定死亡以及竞争原因导致的死亡。然而，近几十年来，乳腺癌生存率的改善主要发生在没有合并症的癌症患者中，而在中度或重度合并症患者中则较少。由于乳腺癌治疗指南主要基于排除中度和重度合并症患者的研究，老年女性合并症患者的代表性不足，因此目前缺乏关于合并症乳腺癌患者治疗有效性的信息。本章描述了合并症对乳腺癌治疗和结局的影响，以前采取的研究方法，以及可能最容易受到合并症对乳腺癌结局影响的特定人群。未来的研究方向建议，可能有助于提高对乳腺癌预后差异的基础共病相关因素的理解，并检查乳腺癌患者中有效管理共病的潜在作用，作为帮助缩小疾病预后差距的策略。
Pre-existing comorbidities negatively impacts overall breast cancer prognosis, increasing both breast cancer specific deaths as well as death from competing causes. Improvements in breast cancer survival in recent decades, however, have primarily been experienced among cancer patients without comorbidities, and less so among those with moderate or severe comorbidities. As guidelines for the treatment of breast cancer are mostly based on studies excluding patients with moderate and severe comorbidities with under-representation of older women with comorbid conditions, information regarding treatment effectiveness in breast cancer patients with comorbidities is currently lacking. This chapter describes the impact of comorbidities on breast cancer treatment and outcomes, previous research approaches taken, and specific populations that may be most susceptible to the effects of comorbidities on breast cancer outcomes. Future research directions are suggested that may help to improve understanding of comorbidity-related factors that underlie disparities in breast cancer outcomes, and to examine the potential role of effective management of comorbidities among breast cancer patients as a strategy to help close gaps in disease prognosis.