Grant Number:	1R01CA081379-01A2 Interpret this number
Primary Investigator:	Nattinger, Ann
Organization:	Medical College Of Wisconsin
Project Title:	Outcomes of Older Women with Early Stage Breast Cancer
Fiscal Year:	2000

DESCRIPTION (Applicant's abstract): Despite recent data showing an overall decrease in mortality from breast cancer, breast cancer mortality rates remain high, particularly among older women. Geographic differences in the breast cancer mortality of older women appear at least partially attributable to survival differences, a finding which implicates cancer control practices. There is much evidence that older women with breast cancer receive less appropriate care than younger women. One factor, which has been shown to influence outcomes of some disease processes, is provider experience, usually measured as the volume of cases seen at a given hospital or handled by a given physician. In this application, we propose to investigate the relationship between breast cancer outcomes and provider volume of cases, in a cohort of older breast cancer patients. The specific aims of this proposal are, among a cohort of SEER patients aged 65 and older, who were treated for early stage breast cancer and for whom Medicare claims are available, to: 1. Determine the treatment hospital and other relevant hospital characteristics (size, urban vs rural status, teaching status, availability of special facilities) for patients in the cohort treated at inpatient or outpatient hospital-based surgical centers. 2. Determine the treating surgeon and other relevant physician characteristics (age, year of medical school, graduation, gender, specialty and board certification). 3. Determine the annual volume of older breast cancer patients treated by each hospital and surgeon treating patients in the cohort. 4. Assess the relationship of annual hospital volume and annual surgeon volume to outcomes of overall 5-year survival, 5-year survival from breast cancer, and 5-year survival free of treatment of recurrent disease.




The interplay between hospital and surgeon factors and the use of sentinel lymph node biopsy for breast cancer.
Authors: Yen T.W. , Li J. , Sparapani R.A. , Laud P.W. , Nattinger A.B. .
Source: Medicine, 2016 Aug; 95(31), p. e4392.
PMID: 27495053
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Identifying patterns of breast cancer care provided at high-volume hospitals: a classification and regression tree analysis.
Authors: Kong A.L. , Pezzin L.E. , Nattinger A.B. .
Source: Breast Cancer Research And Treatment, 2015 Oct; 153(3), p. 689-98.
PMID: 26409836
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An algorithm to identify the development of lymphedema after breast cancer treatment.
Authors: Yen T.W. , Laud P.W. , Sparapani R.A. , Li J. , Nattinger A.B. .
Source: Journal Of Cancer Survivorship : Research And Practice, 2015 Jun; 9(2), p. 161-71.
PMID: 25187004
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Quality of life among a population-based cohort of older patients with breast cancer.
Authors: Neuner J.M. , Zokoe N. , McGinley E.L. , Pezzin L.E. , Yen T.W. , Schapira M.M. , Nattinger A.B. .
Source: Breast (edinburgh, Scotland), 2014 Oct; 23(5), p. 609-16.
PMID: 25034932
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Surgeon specialization and use of sentinel lymph node biopsy for breast cancer.
Authors: Yen T.W. , Laud P.W. , Sparapani R.A. , Nattinger A.B. .
Source: Jama Surgery, 2014 Feb; 149(2), p. 185-92.
PMID: 24369337
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Fracture risk and adjuvant hormonal therapy among a population-based cohort of older female breast cancer patients.
Authors: Neuner J.M. , Yen T.W. , Sparapani R.A. , Laud P.W. , Nattinger A.B. .
Source: Osteoporosis International : A Journal Established As Result Of Cooperation Between The European Foundation For Osteoporosis And The National Osteoporosis Foundation Of The Usa, 2011 Nov; 22(11), p. 2847-55.
PMID: 21170643
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Socioeconomic and racial differences in treatment for breast cancer at a low-volume hospital.
Authors: Kong A.L. , Yen T.W. , Pezzin L.E. , Miao H. , Sparapani R.A. , Laud P.W. , Nattinger A.B. .
Source: Annals Of Surgical Oncology, 2011 Oct; 18(11), p. 3220-7.
PMID: 21861226
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Socioeconomic factors associated with adjuvant hormone therapy use in older breast cancer survivors.
Authors: Yen T.W. , Czypinski L.K. , Sparapani R.A. , Guo C. , Laud P.W. , Pezzin L.E. , Nattinger A.B. .
Source: Cancer, 2011-01-15 00:00:00.0; 117(2), p. 398-405.
EPub date: 2011-01-15 00:00:00.0.
PMID: 20824718
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Heightened attention to medical privacy: challenges for unbiased sample recruitment and a possible solution.
Authors: Nattinger A.B. , Pezzin L.E. , Sparapani R.A. , Neuner J.M. , King T.K. , Laud P.W. .
Source: American Journal Of Epidemiology, 2010-09-15 00:00:00.0; 172(6), p. 637-44.
EPub date: 2010-09-15 00:00:00.0.
PMID: 20660123
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Elderly breast cancer survivors accurately self-report key treatment information.
Authors: Yen T.W. , Sparapani R.A. , Guo C. , Neuner J.M. , Laud P.W. , Nattinger A.B. .
Source: Journal Of The American Geriatrics Society, 2010 Feb; 58(2), p. 410-2.
PMID: 20370882
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The economic consequences of breast cancer adjuvant hormonal treatments.
Authors: Pezzin L.E. , O'Niel M.B. , Nattinger A.B. .
Source: Journal Of General Internal Medicine, 2009 Nov; 24 Suppl 2, p. S446-50.
PMID: 19838848
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A contemporary, population-based study of lymphedema risk factors in older women with breast cancer.
Authors: Yen T.W. , Fan X. , Sparapani R. , Laud P.W. , Walker A.P. , Nattinger A.B. .
Source: Annals Of Surgical Oncology, 2009 Apr; 16(4), p. 979-88.
PMID: 19194754
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Exploring the surgeon volume outcome relationship among women with breast cancer.
Authors: Nattinger A.B. , Laud P.W. , Sparapani R.A. , Zhang X. , Neuner J.M. , Gilligan M.A. .
Source: Archives Of Internal Medicine, 2007-10-08 00:00:00.0; 167(18), p. 1958-63.
PMID: 17923595
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Relationship between number of breast cancer operations performed and 5-year survival after treatment for early-stage breast cancer.
Authors: Gilligan M.A. , Neuner J. , Zhang X. , Sparapani R. , Laud P.W. , Nattinger A.B. .
Source: American Journal Of Public Health, 2007 Mar; 97(3), p. 539-44.
PMID: 17267725
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Surgeon characteristics and variations in treatment for early-stage breast cancer.
Authors: Gilligan M.A. , Neuner J. , Sparapani R. , Laud P.W. , Nattinger A.B. .
Source: Archives Of Surgery (chicago, Ill. : 1960), 2007 Jan; 142(1), p. 17-22.
PMID: 17224496
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Bone density testing in older women and its association with patient age.
Authors: Neuner J.M. , Binkley N. , Sparapani R.A. , Laud P.W. , Nattinger A.B. .
Source: Journal Of The American Geriatrics Society, 2006 Mar; 54(3), p. 485-9.
PMID: 16551317
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Decentralization of breast cancer surgery in the United States.
Authors: Neuner J.M. , Gilligan M.A. , Sparapani R. , Laud P.W. , Haggstrom D. , Nattinger A.B. .
Source: Cancer, 2004-09-15 00:00:00.0; 101(6), p. 1323-9.
PMID: 15368323
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