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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

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 PA
Source: J Cancer Surviv, 2013 Mar;7(1), p. 20-31.
EPub date: 2012 Dec 12.
PMID: 23232922
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The eight-item modified Medical Outcomes Study Social Support Survey: psychometric evaluation showed excellent performance.
Authors: Moser A, Stuck AE, Silliman RA, Ganz PA, Clough-Gorr KM
Source: J Clin Epidemiol, 2012 Oct;65(10), p. 1107-16.
EPub date: 2012 Jul 20.
PMID: 22818947
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Examining five- and ten-year survival in older women with breast cancer using cancer-specific geriatric assessment.
Authors: Clough-Gorr KM, Thwin SS, Stuck AE, Silliman RA
Source: Eur J Cancer, 2012 Apr;48(6), p. 805-12.
EPub date: 2011 Jul 7.
PMID: 21741826
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Longitudinal patterns in survival, comorbidity, healthcare utilization and quality of care among older women following breast cancer diagnosis.
Authors: Hanchate AD, Clough-Gorr KM, Ash AS, Thwin SS, Silliman RA
Source: J Gen Intern Med, 2010 Oct;25(10), p. 1045-50.
EPub date: 2010 Jun 8.
PMID: 20532657
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When cancer in older adults is undermanaged: the breast cancer story.
Authors: Silliman RA
Source: J Am Geriatr Soc, 2009 Nov;57 Suppl 2, p. S259-61.
PMID: 20122024
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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 KM, Stuck AE, Thwin SS, Silliman RA
Source: J Clin Oncol, 2010 Jan 20;28(3), p. 380-6.
EPub date: 2009 Dec 14.
PMID: 20008637
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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 KM, Ganz PA, Silliman RA
Source: Breast J, 2010 Mar-Apr;16(2), p. 147-55.
EPub date: 2009 Nov 24.
PMID: 19968661
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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 KM, Rakowski W, Clark M, Silliman RA
Source: J Psychosoc Oncol, 2009;27(4), p. 454-68.
PMID: 19813135
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Impact of acquired comorbidities on all-cause mortality rates among older breast cancer survivors.
Authors: Ahern TP, Lash TL, Thwin SS, Silliman RA
Source: Med Care, 2009 Jan;47(1), p. 73-9.
PMID: 19106734
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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 JS, Silliman R
Source: J Clin Oncol, 2009 Feb 1;27(4), p. 487-90.
EPub date: 2008 Dec 15.
PMID: 19075258
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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 KM, Fink AK, Silliman RA
Source: J Cancer Surviv, 2008 Jun;2(2), p. 95-103.
EPub date: 2008 Apr 17.
PMID: 18648978
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Older breast cancer survivors: factors associated with change in emotional well-being.
Authors: Clough-Gorr KM, Ganz PA, Silliman RA
Source: J Clin Oncol, 2007 Apr 10;25(11), p. 1334-40.
EPub date: 2007 Feb 20.
PMID: 17312327
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