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National Institutes of Health: National Cancer Institute: Division of Cancer Control and Population Sciences
Grant Details

Grant Number: 5R01CA106979-05 Interpret this number
Primary Investigator: Silliman, Rebecca
Organization: Boston Medical Center
Project Title: Impact of Breast Cancer on Older Survivors
Fiscal Year: 2008
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Abstract

DESCRIPTION (provided by applicant): Recent and anticipated demographic changes in the United States have magnified the concentration of cancer survivors among persons >=65 years of age. At present 60% of the estimated 8.9 million cancer survivors are >=65 years of age and the number of incident cases in this age group is expected to double over the next 30 years. These overall trends are reflected in the specific case of breast cancer. An estimated 203,500 women were diagnosed with breast cancer in 2002, with almost half of the cases occurring in women >=65 years of age. This proportion and the corresponding absolute numbers are likely to grow, because older age is the most important risk factor for breast cancer and because gains in life expectancy will result in more women being at risk for longer periods of time. For these older women, the consequences of breast cancer and its treatment are likely to be complex, due to the interaction of breast cancer treatment sequelae, non-breast cancer comorbidities, and age-related disabilities. We are conducting a multi-site study of over 900 women 65 years of age and older at intermediate and high risk of breast cancer recurrence. We propose to follow this cohort for an average of 10 years following diagnosis to examine the relationships among breast cancer and its treatment, age-related comorbidities and functional impairments, and health outcomes in long-term older breast cancer survivors. Taking advantage of this carefully and comprehensively studied cohort of women whom we have followed since diagnosis, and complemented by Medicare claims data, we will: (1) describe patterns of breast cancer recurrence surveillance and assess the impact of guideline surveillance on breast cancer mortality, all-cause mortality, and health-related quality of life (HRQOL); (2) identify demographic, treatment, and tumor characteristics associated with successful and unsuccessful survivorship with respect to HRQOL, specifically psychosocial and physical function; and (3) determine the impact of a breast cancer diagnosis on total comorbidity burden and quality of non-breast cancer care. Results from the proposed project will provide new information about the large and growing number of older women who are long-term survivors of breast cancer. Understanding their physical, psychological, and medical and oncological care needs will inform the future care of older women with this disease.

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Publications

Older Breast Cancer Survivors: Factors Associated With Change In Emotional Well-being
Authors: Clough-Gorr K.M. , Ganz P.A. , Silliman R.A. .
Source: Journal Of Clinical Oncology : Official Journal Of The American Society Of Clinical Oncology, 2007-04-10 00:00:00.0; 25(11), p. 1334-40.
PMID: 17312327
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Challenges Associated With Longitudinal Survivorship Research: Attrition And A Novel Approach Of Reenrollment In A 6-year Follow-up Study Of Older Breast Cancer Survivors
Authors: Clough-Gorr K.M. , Fink A.K. , Silliman R.A. .
Source: Journal Of Cancer Survivorship : Research And Practice, 2008 Jun; 2(2), p. 95-103.
PMID: 18648978
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Hanging In The Balance: Making Decisions About The Benefits And Harms Of Breast Cancer Screening Among The Oldest Old Without A Safety Net Of Scientific Evidence
Authors: Mandelblatt J.S. , Silliman R. .
Source: Journal Of Clinical Oncology : Official Journal Of The American Society Of Clinical Oncology, 2009-02-01 00:00:00.0; 27(4), p. 487-90.
PMID: 19075258
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Impact Of Acquired Comorbidities On All-cause Mortality Rates Among Older Breast Cancer Survivors
Authors: Ahern T.P. , Lash T.L. , Thwin S.S. , Silliman R.A. .
Source: Medical Care, 2009 Jan; 47(1), p. 73-9.
PMID: 19106734
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The Getting-out-of-bed (gob) Scale: A Measure Of Motivation And Life Outlook In Older Adults With Cancer
Authors: Clough-Gorr K.M. , Rakowski W. , Clark M. , Silliman R.A. .
Source: Journal Of Psychosocial Oncology, 2009; 27(4), p. 454-68.
PMID: 19813135
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Older Breast Cancer Survivors: Factors Associated With Self-reported Symptoms Of Persistent Lymphedema Over 7 Years Of Follow-up
Authors: Clough-Gorr K.M. , Ganz P.A. , Silliman R.A. .
Source: The Breast Journal, 2010 Mar-Apr; 16(2), p. 147-55.
PMID: 19968661
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Older Breast Cancer Survivors: Geriatric Assessment Domains Are Associated With Poor Tolerance Of Treatment Adverse Effects And Predict Mortality Over 7 Years Of Follow-up
Authors: Clough-Gorr K.M. , Stuck A.E. , Thwin S.S. , Silliman R.A. .
Source: Journal Of Clinical Oncology : Official Journal Of The American Society Of Clinical Oncology, 2010-01-20 00:00:00.0; 28(3), p. 380-6.
PMID: 20008637
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When Cancer In Older Adults Is Undermanaged: The Breast Cancer Story
Authors: Silliman R.A. .
Source: Journal Of The American Geriatrics Society, 2009 Nov; 57 Suppl 2, p. S259-61.
PMID: 20122024
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Longitudinal Patterns In Survival, Comorbidity, Healthcare Utilization And Quality Of Care Among Older Women Following Breast Cancer Diagnosis
Authors: Hanchate A.D. , Clough-Gorr K.M. , Ash A.S. , Thwin S.S. , Silliman R.A. .
Source: Journal Of General Internal Medicine, 2010 Oct; 25(10), p. 1045-50.
PMID: 20532657
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Examining Five- And Ten-year Survival In Older Women With Breast Cancer Using Cancer-specific Geriatric Assessment
Authors: Clough-Gorr K.M. , Thwin S.S. , Stuck A.E. , Silliman R.A. .
Source: European Journal Of Cancer (oxford, England : 1990), 2012 Apr; 48(6), p. 805-12.
PMID: 21741826
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The Eight-item Modified Medical Outcomes Study Social Support Survey: Psychometric Evaluation Showed Excellent Performance
Authors: Moser A. , Stuck A.E. , Silliman R.A. , Ganz P.A. , Clough-Gorr K.M. .
Source: Journal Of Clinical Epidemiology, 2012 Oct; 65(10), p. 1107-16.
PMID: 22818947
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Decline In Physical Functioning In First 2 Years After Breast Cancer Diagnosis Predicts 10-year Survival In Older Women
Authors: Sehl M. , Lu X. , Silliman R. , Ganz P.A. .
Source: Journal Of Cancer Survivorship : Research And Practice, 2013 Mar; 7(1), p. 20-31.
PMID: 23232922
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Predicting 5- And 10-year Survival In Older Women With Early-stage Breast Cancer: Self-rated Health And Walking Ability
Authors: Eng J.A. , Clough-Gorr K. , Cabral H.J. , Silliman R.A. .
Source: Journal Of The American Geriatrics Society, 2015 Apr; 63(4), p. 757-62.
PMID: 25900489
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