Grant Details
Grant Number: |
1R01CA127617-01A1 Interpret this number |
Primary Investigator: |
Mandelblatt, Jeanne |
Organization: |
Georgetown University |
Project Title: |
Who Cares for Older Breast Cancer Surivors and How Does It Affect Quality? |
Fiscal Year: |
2008 |
Abstract
DESCRIPTION (provided by applicant): Despite the demographic imperative of a rapidly growing older US population, increasing life expectancy, and rising cancer rates with advancing age, there is a paucity of research on older (65+ years) survivors. This project leverages NCI's investment in an extant cohort of older women with breast cancer to address new scientific questions about survivorship care. In this study, we use the Institute of Medicine's (IOM) framework based on Donadebian's model of structure, process and outcomes to determine who cares for this cohort of older survivors after active treatment ends and how the type of provider affects quality of care. The cohort includes 1100 older English and Spanish speaking breast cancer patients with detailed baseline data. Women were diagnosed between late 2005 and 2007 in 106 Cancer and Leukemia Group B (CALGB) institutions; 90% of the sites are in community settings. The cohort is representative of the US population of breast cancer patients in terms of race/ethnicity, insurance coverage and community settings of care; half would be considered low SES based on education and one-third live in areas of high poverty. Our multidisciplinary team will conduct annual telephone follow-up interviews over five years post active-treatment to examine care choices and experiences, symptoms, quality of life and satisfaction. These data will be linked to Medicare claims from the 18 months prior to five years post-active treatment to define baseline patterns and post- treatment providers and services. We will also use AMA files to obtain physician characteristics (specialty, gender, and race) and survivor's addresses to include census data on area characteristics. Our primary outcomes will be rates of services from claims (e.g., cumulative use of mammography among survivors) and patient-rated satisfaction and quality of life. The key predictor is model of survivorship care (shared by an oncologist and primary care provider or a primary care provider alone); we will assess whether communication and/or coordination mediate outcomes. Finally, we will conduct in-depth, open ended interviews among a sub- set of minority and non-minority women each year to enhance our ability to understand whether there are race/ethnicity differences in care. The use of an established cohort allows us to collect new data in a cost- efficient manner; this research also addresses a key priority for survivorship research as articulated by the IOM. Patterns of care that maximize quality of life and functioning are particularly salient in older women, where declines may exacerbate frailty and ability to live independently. We will use project data to guide future interventions to improve outcomes and inform clinical practice and policy decisions about care models that maximize quality for the growing older population of breast cancer survivors. Despite the demographic imperative of a rapidly growing older US population there is a paucity of research on older (65+ years) survivors. This project will examine whether care in the first five years after active treatment ends that is shared by an oncologist and primary care physician results in better quality care, satisfaction and quality of life for older survivors than care provided by a primary care physician alone. Results will be used to guide future interventions to improve outcomes and inform clinical practice and policy decisions about care models that maximize quality for the growing older population of breast cancer survivors. Patterns of care that maximize quality of life and functioning are particularly salient in older women, where declines may exacerbate frailty and ability to live independently.
Publications
Deficit accumulation frailty index (DAFI) and treatment tolerability in AML: Data from CALGB 11001 and 11002 (Alliance).
Authors: Lai C.
, Lee M.
, Bobek O.
, Le-Rademacher J.
, Mandrekar S.J.
, Roboz G.J.
, Uy G.L.
, Mandelblatt J.
, Klepin H.D.
.
Source: Blood Advances, 2024-11-27 00:00:00.0; , .
EPub date: 2024-11-27 00:00:00.0.
PMID: 39602659
Related Citations
Functional Decline and Resilience in Older Women Receiving Adjuvant Chemotherapy for Breast Cancer.
Authors: Hurria A.
, Soto-Perez-de-Celis E.
, Allred J.B.
, Cohen H.J.
, Arsenyan A.
, Ballman K.
, Le-Rademacher J.
, Jatoi A.
, Filo J.
, Mandelblatt J.
, et al.
.
Source: Journal Of The American Geriatrics Society, 2019 May; 67(5), p. 920-927.
EPub date: 2018-08-26 00:00:00.0.
PMID: 30146695
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The Impact of Using Different Reference Populations on Measurement of Breast Cancer-Related Cognitive Impairment Rates.
Authors: Clapp J.D.
, Luta G.
, Small B.J.
, Ahles T.A.
, Root J.C.
, Graham D.
, Hurria A.
, Jacobsen P.B.
, Jim H.
, McDonald B.C.
, et al.
.
Source: Archives Of Clinical Neuropsychology : The Official Journal Of The National Academy Of Neuropsychologists, 2018-02-17 00:00:00.0; , .
EPub date: 2018-02-17 00:00:00.0.
PMID: 29471454
Related Citations
Frailty and long-term mortality of older breast cancer patients: CALGB 369901 (Alliance).
Authors: Mandelblatt J.S.
, Cai L.
, Luta G.
, Kimmick G.
, Clapp J.
, Isaacs C.
, Pitcher B.
, Barry W.
, Winer E.
, Sugarman S.
, et al.
.
Source: Breast Cancer Research And Treatment, 2017 Jul; 164(1), p. 107-117.
EPub date: 2017-03-31 00:00:00.0.
PMID: 28364214
Related Citations
Cognitive function and discontinuation of adjuvant hormonal therapy in older breast cancer survivors: CALGB 369901 (Alliance).
Authors: Bluethmann S.M.
, Alfano C.M.
, Clapp J.D.
, Luta G.
, Small B.J.
, Hurria A.
, Cohen H.J.
, Sugarman S.
, B Muss H.
, Isaacs C.
, et al.
.
Source: Breast Cancer Research And Treatment, 2017-06-26 00:00:00.0; , .
EPub date: 2017-06-26 00:00:00.0.
PMID: 28653250
Related Citations
Using Eprognosis To Estimate 2-year All-cause Mortality In Older Women With Breast Cancer: Cancer And Leukemia Group B (calgb) 49907 And 369901 (alliance A151503)
Authors: Kimmick G.G.
, Major B.
, Clapp J.
, Sloan J.
, Pitcher B.
, Ballman K.
, Barginear M.
, Freedman R.A.
, Artz A.
, Klepin H.D.
, et al.
.
Source: Breast Cancer Research And Treatment, 2017-03-10 00:00:00.0; , .
PMID: 28283904
Related Citations
Personality, coping, and social support as predictors of long-term quality-of-life trajectories in older breast cancer survivors: CALGB protocol 369901 (Alliance).
Authors: DurĂ¡-Ferrandis E.
, Mandelblatt J.S.
, Clapp J.
, Luta G.
, Faul L.
, Kimmick G.
, Cohen H.J.
, Yung R.L.
, Hurria A.
.
Source: Psycho-oncology, 2017-02-20 00:00:00.0; , .
EPub date: 2017-02-20 00:00:00.0.
PMID: 28219113
Related Citations
Long-term trajectories of self-reported cognitive function in a cohort of older survivors of breast cancer: CALGB 369901 (Alliance).
Authors: Mandelblatt J.S.
, Clapp J.D.
, Luta G.
, Faul L.A.
, Tallarico M.D.
, McClendon T.D.
, Whitley J.A.
, Cai L.
, Ahles T.A.
, Stern R.A.
, et al.
.
Source: Cancer, 2016-07-22 00:00:00.0; , .
EPub date: 2016-07-22 00:00:00.0.
PMID: 27447359
Related Citations
Disparities In Breast Cancer Surgery Delay: The Lingering Effect Of Race
Authors: Sheppard V.B.
, Oppong B.A.
, Hampton R.
, Snead F.
, Horton S.
, Hirpa F.
, Brathwaite E.J.
, Makambi K.
, Onyewu S.
, Boisvert M.
, et al.
.
Source: Annals Of Surgical Oncology, 2015 Sep; 22(9), p. 2902-11.
PMID: 25652051
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Risk-reduction Opportunities In Breast Cancer Survivors: Capitalizing On Teachable Moments
Authors: Highland K.B.
, Hurtado-de-Mendoza A.
, Stanton C.A.
, Dash C.
, Sheppard V.B.
.
Source: Supportive Care In Cancer : Official Journal Of The Multinational Association Of Supportive Care In Cancer, 2015 Apr; 23(4), p. 933-41.
PMID: 25239599
Related Citations
Associations Among Survivorship Care Plans, Experiences Of Survivorship Care, And Functioning In Older Breast Cancer Survivors: Calgb/alliance 369901
Authors: Faul L.A.
, Luta G.
, Sheppard V.
, Isaacs C.
, Cohen H.J.
, Muss H.B.
, Yung R.
, Clapp J.D.
, Winer E.
, Hudis C.
, et al.
.
Source: Journal Of Cancer Survivorship : Research And Practice, 2014 Dec; 8(4), p. 627-37.
PMID: 24917307
Related Citations
Non-initiation and early discontinuation of adjuvant trastuzumab in women with localized HER2-positive breast cancer.
Authors: Neugut A.I.
, Hillyer G.C.
, Kushi L.H.
, Lamerato L.
, Leoce N.
, Ambrosone C.B.
, Bovbjerg D.H.
, Mandelblatt J.S.
, Hershman D.L.
.
Source: Breast Cancer (tokyo, Japan), 2014 Nov; 21(6), p. 780-5.
PMID: 24902664
Related Citations
Cognitive effects of cancer systemic therapy: implications for the care of older patients and survivors.
Authors: Mandelblatt J.S.
, Jacobsen P.B.
, Ahles T.
.
Source: Journal Of Clinical Oncology : Official Journal Of The American Society Of Clinical Oncology, 2014-08-20 00:00:00.0; 32(24), p. 2617-26.
EPub date: 2014-08-20 00:00:00.0.
PMID: 25071135
Related Citations
Frailty And Adherence To Adjuvant Hormonal Therapy In Older Women With Breast Cancer: Calgb Protocol 369901
Authors: Sheppard V.B.
, Faul L.A.
, Luta G.
, Clapp J.D.
, Yung R.L.
, Wang J.H.
, Kimmick G.
, Isaacs C.
, Tallarico M.
, Barry W.T.
, et al.
.
Source: Journal Of Clinical Oncology : Official Journal Of The American Society Of Clinical Oncology, 2014-08-01 00:00:00.0; 32(22), p. 2318-27.
PMID: 24934786
Related Citations
Cognitive Impairment In Older Patients With Breast Cancer Before Systemic Therapy: Is There An Interaction Between Cancer And Comorbidity?
Authors: Mandelblatt J.S.
, Stern R.A.
, Luta G.
, McGuckin M.
, Clapp J.D.
, Hurria A.
, Jacobsen P.B.
, Faul L.A.
, Isaacs C.
, Denduluri N.
, et al.
.
Source: Journal Of Clinical Oncology : Official Journal Of The American Society Of Clinical Oncology, 2014-06-20 00:00:00.0; 32(18), p. 1909-18.
PMID: 24841981
Related Citations
Cognitive effects of cancer and its treatments at the intersection of aging: what do we know; what do we need to know?
Authors: Mandelblatt J.S.
, Hurria A.
, McDonald B.C.
, Saykin A.J.
, Stern R.A.
, VanMeter J.W.
, McGuckin M.
, Traina T.
, Denduluri N.
, Turner S.
, et al.
.
Source: Seminars In Oncology, 2013 Dec; 40(6), p. 709-25.
PMID: 24331192
Related Citations
A Planned, Prospective Comparison Of Short-term Quality Of Life Outcomes Among Older Patients With Breast Cancer Treated With Standard Chemotherapy In A Randomized Clinical Trial Vs. An Observational Study: Calgb #49907 And #369901
Authors: Mandelblatt J.S.
, Makgoeng S.B.
, Luta G.
, Hurria A.
, Kimmick G.
, Isaacs C.
, Tallarico M.
, Barry W.T.
, Pitcher B.
, Winer E.P.
, et al.
.
Source: Journal Of Geriatric Oncology, 2013 Oct; 4(4), p. 353-61.
PMID: 24472479
Related Citations
A survey of breast cancer physicians regarding patient involvement in breast cancer treatment decisions.
Authors: Hillyer G.C.
, Hershman D.L.
, Kushi L.H.
, Lamerato L.
, Ambrosone C.B.
, Bovbjerg D.H.
, Mandelblatt J.S.
, Rana S.
, Neugut A.I.
.
Source: Breast (edinburgh, Scotland), 2013 Aug; 22(4), p. 548-54.
PMID: 23107518
Related Citations
A Peer-led Decision Support Intervention Improves Decision Outcomes In Black Women With Breast Cancer
Authors: Sheppard V.B.
, Wallington S.F.
, Willey S.C.
, Hampton R.M.
, Lucas W.
, Jennings Y.
, Horton S.
, Muzeck N.
, Cocilovo C.
, Isaacs C.
.
Source: Journal Of Cancer Education : The Official Journal Of The American Association For Cancer Education, 2013 Jun; 28(2), p. 262-9.
PMID: 23576067
Related Citations
Cognitive Function In Older Women With Breast Cancer Treated With Standard Chemotherapy And Capecitabine On Cancer And Leukemia Group B 49907
Authors: Freedman R.A.
, Pitcher B.
, Keating N.L.
, Ballman K.V.
, Mandelblatt J.
, Kornblith A.B.
, Kimmick G.G.
, Hurria A.
, Winer E.P.
, Hudis C.A.
, et al.
.
Source: Breast Cancer Research And Treatment, 2013 Jun; 139(2), p. 607-16.
PMID: 23681403
Related Citations
Narrowing Racial Gaps In Breast Cancer Chemotherapy Initiation: The Role Of The Patient-provider Relationship
Authors: Sheppard V.B.
, Isaacs C.
, Luta G.
, Willey S.C.
, Boisvert M.
, Harper F.W.
, Smith K.
, Horton S.
, Liu M.C.
, Jennings Y.
, et al.
.
Source: Breast Cancer Research And Treatment, 2013 May; 139(1), p. 207-16.
PMID: 23588954
Related Citations
Racial disparities in posttraumatic stress after diagnosis of localized breast cancer: the BQUAL study.
Authors: Vin-Raviv N.
, Hillyer G.C.
, Hershman D.L.
, Galea S.
, Leoce N.
, Bovbjerg D.H.
, Kushi L.H.
, Kroenke C.
, Lamerato L.
, Ambrosone C.B.
, et al.
.
Source: Journal Of The National Cancer Institute, 2013-04-17 00:00:00.0; 105(8), p. 563-72.
EPub date: 2013-04-17 00:00:00.0.
PMID: 23434900
Related Citations
Interpersonal influences and attitudes about adjuvant therapy treatment decisions among non-metastatic breast cancer patients: an examination of differences by age and race/ethnicity in the BQUAL study.
Authors: Shelton R.C.
, Clarke Hillyer G.
, Hershman D.L.
, Leoce N.
, Bovbjerg D.H.
, Mandelblatt J.S.
, Kushi L.H.
, Lamerato L.
, Nathanson S.D.
, Ambrosone C.B.
, et al.
.
Source: Breast Cancer Research And Treatment, 2013 Feb; 137(3), p. 817-28.
PMID: 23263696
Related Citations
Noninitiation of adjuvant chemotherapy in women with localized breast cancer: the breast cancer quality of care study.
Authors: Neugut A.I.
, Hillyer G.C.
, Kushi L.H.
, Lamerato L.
, Leoce N.
, Nathanson S.D.
, Ambrosone C.B.
, Bovbjerg D.H.
, Mandelblatt J.S.
, Magai C.
, et al.
.
Source: Journal Of Clinical Oncology : Official Journal Of The American Society Of Clinical Oncology, 2012-11-01 00:00:00.0; 30(31), p. 3800-9.
EPub date: 2012-11-01 00:00:00.0.
PMID: 23008305
Related Citations
Patient and physician decision styles and breast cancer chemotherapy use in older women: Cancer and Leukemia Group B protocol 369901.
Authors: Mandelblatt J.S.
, Faul L.A.
, Luta G.
, Makgoeng S.B.
, Isaacs C.
, Taylor K.
, Sheppard V.B.
, Tallarico M.
, Barry W.T.
, Cohen H.J.
.
Source: Journal Of Clinical Oncology : Official Journal Of The American Society Of Clinical Oncology, 2012-07-20 00:00:00.0; 30(21), p. 2609-14.
EPub date: 2012-07-20 00:00:00.0.
PMID: 22614985
Related Citations
Non-initiation of adjuvant hormonal therapy in women with hormone receptor-positive breast cancer: The Breast Cancer Quality of Care Study (BQUAL).
Authors: Neugut A.I.
, Hillyer G.C.
, Kushi L.H.
, Lamerato L.
, Leoce N.
, Nathanson S.D.
, Ambrosone C.B.
, Bovbjerg D.H.
, Mandelblatt J.S.
, Magai C.
, et al.
.
Source: Breast Cancer Research And Treatment, 2012 Jul; 134(1), p. 419-28.
PMID: 22527111
Related Citations
The Breast Cancer Quality of Care Study (BQUAL): a multi-center study to determine causes for noncompliance with breast cancer adjuvant therapy.
Authors: Neugut A.I.
, Hillyer G.C.
, Kushi L.H.
, Lamerato L.
, Nathanson S.D.
, Ambrosone C.B.
, Bovbjerg D.H.
, Mandelblatt J.S.
, Magai C.
, Tsai W.Y.
, et al.
.
Source: The Breast Journal, 2012 May-Jun; 18(3), p. 203-13.
PMID: 22487337
Related Citations
Associations of physical activity with quality of life and functional ability in breast cancer patients during active adjuvant treatment: the Pathways Study.
Authors: Mandelblatt J.S.
, Luta G.
, Kwan M.L.
, Makgoeng S.B.
, Ergas I.J.
, Roh J.M.
, Sternfeld B.
, Adams-Campbell L.L.
, Kushi L.H.
.
Source: Breast Cancer Research And Treatment, 2011 Sep; 129(2), p. 521-9.
PMID: 21476003
Related Citations
Quality of life among women recently diagnosed with invasive breast cancer: the Pathways Study.
Authors: Kwan M.L.
, Ergas I.J.
, Somkin C.P.
, Quesenberry C.P.
, Neugut A.I.
, Hershman D.L.
, Mandelblatt J.
, Pelayo M.P.
, Timperi A.W.
, Miles S.Q.
, et al.
.
Source: Breast Cancer Research And Treatment, 2010 Sep; 123(2), p. 507-24.
PMID: 20140494
Related Citations
Breast Cancer Adjuvant Chemotherapy Decisions In Older Women: The Role Of Patient Preference And Interactions With Physicians
Authors: Mandelblatt,J.S.
, Sheppard,V.B.
, Hurria,A.
, Kimmick,G.
, Isaacs,C.
, Taylor,K.L.
, Kornblith,A.B.
, Noone,A.M.
, Luta,G.
, Tallarico,M.
, et al.
.
Source: Journal Of Clinical Oncology : Official Journal Of The American Society Of Clinical Oncology, 2010-07-01 00:00:00.0; 28(19), p. 3146-53.
PMID: 20516438
Related Citations
Development Of Decision-support Intervention For Black Women With Breast Cancer
Authors: Sheppard,V.B.
, Williams,K.P.
, Harrison,T.M.
, Jennings,Y.
, Lucas,W.
, Stephen,J.
, Robinson,D.
, Mandelblatt,J.S.
, Taylor,K.L.
.
Source: Psycho-oncology, 2010 Jan; 19(1), p. 62-70.
PMID: 19267384
Related Citations
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.
EPub date: 2009-02-01 00:00:00.0.
PMID: 19075258
Related Citations
On The Road To Improving The Quality Of Breast Cancer Care: A Distance Still To Travel
Authors: Mandelblatt,J.S.
, Potosky,A.L.
.
Source: Medical Care, 2008 Aug; 46(8), p. 759-61.
PMID: 18665054
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