2023
Relative Burden of Cancer and Noncancer Mortality Among Long-Term Survivors of Breast, Prostate, and Colorectal Cancer in the US
Kc M, Fan J, Hyslop T, Hassan S, Cecchini M, Wang S, Silber A, Leapman M, Leeds I, Wheeler S, Spees L, Gross C, Lustberg M, Greenup R, Justice A, Oeffinger K, Dinan M. Relative Burden of Cancer and Noncancer Mortality Among Long-Term Survivors of Breast, Prostate, and Colorectal Cancer in the US. JAMA Network Open 2023, 6: e2323115. PMID: 37436746, PMCID: PMC10339147, DOI: 10.1001/jamanetworkopen.2023.23115.Peer-Reviewed Original ResearchConceptsLong-term survivorsCancer-specific mortalityColorectal cancerCancer cohortReceptor statusInitial diagnosisGleason scoreProstate cancerBreast cancerLong-term adult survivorsMedian cancer-specific survivalEnd Results cancer registryProstate-specific antigen levelRectal cancer cohortCancer-specific survivalStage III diseaseYear of diagnosisProgesterone receptor statusEstrogen receptor statusProportion of deathsSurvival time ratioEarly-stage cancerNononcologic outcomesIndex cancerLocalized diseaseDemographic and clinical factors associated with cardiovascular events in elderly long-term survivors of breast cancer.
Westvold S, KC M, Fan J, Hyslop T, Spees L, Wang S, Silber A, Oeffinger K, Dinan M. Demographic and clinical factors associated with cardiovascular events in elderly long-term survivors of breast cancer. Journal Of Clinical Oncology 2023, 41: e24105-e24105. DOI: 10.1200/jco.2023.41.16_suppl.e24105.Peer-Reviewed Original ResearchLong-term breast cancer survivorsBreast cancer survivorsLong-term survivorsCardiovascular diseaseCancer survivorsHigh riskCancer stageRace/ethnicityClinical characteristicsDiagnosis yearBreast cancerEvidence of CVDNon-Hispanic black patientsNon-metastatic breast cancerLong-term cancer survivorsCox proportional hazards modelCurative-intent surgeryCVD hazard ratiosNon-oncologic outcomesCancer-specific survivalStage III diseaseInitial cancer diagnosisDiagnosis of CVDRace/ethnicity groupsChi-square test
2020
Cost-Effectiveness of Neoadjuvant-Adjuvant Treatment Strategies for Women With ERBB2 (HER2)–Positive Breast Cancer
Kunst N, Wang SY, Hood A, Mougalian SS, DiGiovanna MP, Adelson K, Pusztai L. Cost-Effectiveness of Neoadjuvant-Adjuvant Treatment Strategies for Women With ERBB2 (HER2)–Positive Breast Cancer. JAMA Network Open 2020, 3: e2027074. PMID: 33226431, PMCID: PMC7684449, DOI: 10.1001/jamanetworkopen.2020.27074.Peer-Reviewed Original ResearchMeSH KeywordsAdo-Trastuzumab EmtansineAdultAgedAnthracyclinesAntibodies, Monoclonal, HumanizedAntineoplastic Agents, ImmunologicalAntineoplastic Agents, PhytogenicBreast NeoplasmsCase-Control StudiesCost-Benefit AnalysisCross-Linking ReagentsDrug Therapy, CombinationFemaleHumansImmunosuppressive AgentsMiddle AgedNeoadjuvant TherapyPaclitaxelQuality-Adjusted Life YearsReceptor, ErbB-2TrastuzumabTubulin ModulatorsUnited StatesConceptsErbB2-positive breast cancerAdjuvant treatment strategiesAdjuvant T-DM1Pathologic complete responseT-DM1Treatment strategiesBreast cancerKATHERINE trialResidual diseaseNeoadjuvant regimenHigher health benefitsHealth care payer perspectiveAdjuvant trastuzumab emtansineAnthracycline/cyclophosphamideDifferent adjuvant therapiesFlatiron Health databaseIncremental cost-effectiveness ratioNeoadjuvant treatment optionsHealth benefitsPositive breast cancerCare payer perspectiveCost-effectiveness ratioBase-case analysisDecision analytic modelH. Patients
2019
“Radiotherapy for older women (ROW)”: A risk calculator for women with early-stage breast cancer
Wang SY, Abujarad F, Chen T, Evans SB, Killelea BK, Mougalian SS, Fraenkel L, Gross C. “Radiotherapy for older women (ROW)”: A risk calculator for women with early-stage breast cancer. Journal Of Geriatric Oncology 2019, 11: 850-859. PMID: 31899199, PMCID: PMC7263974, DOI: 10.1016/j.jgo.2019.12.010.Peer-Reviewed Original ResearchConceptsEarly-stage breast cancerRisk calculatorLocal recurrenceBreast cancerOlder womenTumor characteristicsBreast cancer-specific outcomesReceipt of radiotherapyCancer-specific outcomesEarly breast cancerIndividual patient's riskBenefits of radiotherapyAdvisory CommitteeLife expectancyOnline risk calculatorLong-term survivalShared decision makingBenefit of RTOlder adult womenRadiotherapy statusCause mortalityOverall survivalRecurrence reductionFunctional statusPatient riskA Value of Information Analysis of Research on the 21-Gene Assay for Breast Cancer Management
Kunst NR, Alarid-Escudero F, Paltiel AD, Wang SY. A Value of Information Analysis of Research on the 21-Gene Assay for Breast Cancer Management. Value In Health 2019, 22: 1102-1110. PMID: 31563252, PMCID: PMC7343670, DOI: 10.1016/j.jval.2019.05.004.Peer-Reviewed Original ResearchConceptsEarly-stage breast cancerObservational studyBreast cancerLow-risk early-stage breast cancerHormone receptor-positive early-stage breast cancerPredictive valueLow-risk womenProspective observational studyHigh-risk womenRetrospective observational studyBreast cancer managementQuality-adjusted life yearsCost-effectiveness findingsTraditional risk predictionAdjuvant chemotherapyChemotherapy useAlternative study designsOncotype DXCancer managementClinical utilityCurrent evidenceInsufficient evidenceLife yearsRoutine useStudy designIncorporating Tumor Characteristics to Maximize 21-Gene Assay Utility: A Cost-Effectiveness Analysis.
Wang SY, Chen T, Dang W, Mougalian SS, Evans SB, Gross CP. Incorporating Tumor Characteristics to Maximize 21-Gene Assay Utility: A Cost-Effectiveness Analysis. Journal Of The National Comprehensive Cancer Network 2019, 17: 39-46. PMID: 30659128, DOI: 10.6004/jnccn.2018.7077.Peer-Reviewed Original ResearchMeSH KeywordsAgedAntineoplastic Combined Chemotherapy ProtocolsBiomarkers, TumorBreast NeoplasmsChemotherapy, AdjuvantClinical Decision-MakingConnecticutCost-Benefit AnalysisDecision Support TechniquesFemaleGene Expression ProfilingGenetic TestingHumansMarkov ChainsMastectomyMiddle AgedModels, StatisticalNeoplasm Recurrence, LocalPrevalencePrognosisQuality-Adjusted Life YearsRisk AssessmentConceptsIncremental cost-effectiveness ratioClinical risk groupsQuality-adjusted life yearsHigh-risk groupLow-risk groupOncotype DXRisk groupsBreast cancerLymph node-negative breast cancerDifferent clinical risk groupsLow-risk breast cancerNode-negative breast cancerIntermediate-risk groupRecurrence score (RS) distributionConnecticut Tumor RegistryER-positive diseaseUS payer perspectivePopulation-based dataCost-effectiveness ratioProbabilistic sensitivity analysesCost-effectiveness analysisODX resultsClinical characteristicsMost patientsPatient age
2018
Associations of preoperative breast magnetic resonance imaging with subsequent mastectomy and breast cancer mortality
Wang SY, Long JB, Killelea BK, Evans SB, Roberts KB, Silber AL, Davidoff AJ, Sedghi T, Gross CP. Associations of preoperative breast magnetic resonance imaging with subsequent mastectomy and breast cancer mortality. Breast Cancer Research And Treatment 2018, 172: 453-461. PMID: 30099634, PMCID: PMC6193824, DOI: 10.1007/s10549-018-4919-3.Peer-Reviewed Original ResearchConceptsBreast-conserving surgeryBreast cancer mortalitySubsequent mastectomyCancer mortalityPre-operative MRIBreast cancerSubgroup analysisStage I/II breast cancerEnd Results-Medicare datasetPreoperative breast magnetic resonanceEarly-stage breast cancerMagnetic resonance imaging useReceipt of radiotherapyBreast magnetic resonanceClinical outcomesCox regressionResultsOur sampleImproved outcomesAdjusted ratesMRI useOlder womenLower riskMastectomyImaging useRadiotherapyCost-Effectiveness Analyses of the 21-Gene Assay in Breast Cancer: Systematic Review and Critical Appraisal.
Wang SY, Dang W, Richman I, Mougalian SS, Evans SB, Gross CP. Cost-Effectiveness Analyses of the 21-Gene Assay in Breast Cancer: Systematic Review and Critical Appraisal. Journal Of Clinical Oncology 2018, 36: 1619-1627. PMID: 29659329, PMCID: PMC5978470, DOI: 10.1200/jco.2017.76.5941.Peer-Reviewed Original ResearchConceptsCost-effectiveness analysisChemotherapy useBreast cancerEarly-stage breast cancerStudy designIncremental cost-effectiveness ratioODX recurrence scoreHigh-risk patientsLow-risk patientsRisk of biasCost-effectiveness ratioCost-effectiveness estimatesIndustry fundingDistant recurrenceIndustry-funded studiesClinical characteristicsTumor characteristicsRecurrence scoreChemotherapy decisionsScore groupClinical practiceSystematic reviewODXPatientsCancer
2017
Are Small Breast Cancers Good because They Are Small or Small because They Are Good?
Lannin DR, Wang S. Are Small Breast Cancers Good because They Are Small or Small because They Are Good? New England Journal Of Medicine 2017, 376: 2286-91. PMID: 28591529, DOI: 10.1056/nejmsr1613680.Peer-Reviewed Original ResearchThe Impact of Social Contagion on Physician Adoption of Advanced Imaging Tests in Breast Cancer
Pollack CE, Soulos PR, Herrin J, Xu X, Christakis NA, Forman HP, Yu JB, Killelea BK, Wang SY, Gross CP. The Impact of Social Contagion on Physician Adoption of Advanced Imaging Tests in Breast Cancer. Journal Of The National Cancer Institute 2017, 109: djw330. PMID: 28376191, PMCID: PMC6059114, DOI: 10.1093/jnci/djw330.Peer-Reviewed Original ResearchConceptsMagnetic resonance imagingBaseline usePositron emission tomography scanEnd Results-MedicareEmission tomography scanBreast cancer practiceImaging modalitiesAdvanced imaging testsHierarchical logistic regression modelsLogistic regression modelsPatient characteristicsUnproven benefitCancer practiceMRI/PETTomography scanBreast cancerMRI useImaging testsClinical practicePET useResonance imagingPET imagingPhysician peersPhysician adoptionBaseline periodRacial and Ethnic Disparities in Oncotype DX Test Receipt in a Statewide Population-Based Study.
Davis BA, Aminawung JA, Abu-Khalaf MM, Evans SB, Su K, Mehta R, Wang SY, Gross CP. Racial and Ethnic Disparities in Oncotype DX Test Receipt in a Statewide Population-Based Study. Journal Of The National Comprehensive Cancer Network 2017, 15: 346-354. PMID: 28275035, DOI: 10.6004/jnccn.2017.0034.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overBiomarkers, TumorBreast NeoplasmsConnecticutFemaleGene Expression ProfilingGenetic TestingHealth Services AccessibilityHealthcare DisparitiesHumansLymphatic MetastasisMiddle AgedNeoplasm GradingNeoplasm StagingOdds RatioPatient Outcome AssessmentPopulation SurveillanceRegistriesRetrospective StudiesSocioeconomic FactorsYoung AdultConceptsPopulation-based studyOncotype DXODX testingBreast cancerHispanic womenHormone receptor-positive breast cancerReceptor-positive breast cancerRetrospective population-based studyWhite womenRacial disparitiesGEP test resultsBreast cancer careBreast cancer outcomesStudy inclusion criteriaGene expression profiling testsMore white womenClinical characteristicsTest receiptCancer outcomesCancer careInclusion criteriaLogistic analysisEthnic disparitiesStatewide populationWomenInformation Needs of Older Women With Early-Stage Breast Cancer When Making Radiation Therapy Decisions
Wang SY, Kelly G, Gross C, Killelea BK, Mougalian S, Presley C, Fraenkel L, Evans SB. Information Needs of Older Women With Early-Stage Breast Cancer When Making Radiation Therapy Decisions. International Journal Of Radiation Oncology • Biology • Physics 2017, 98: 733-740. PMID: 28366581, PMCID: PMC5468466, DOI: 10.1016/j.ijrobp.2017.02.001.Peer-Reviewed Original ResearchConceptsRadiation therapy decisionsEarly-stage breast cancerTherapy decisionsOlder womenRadiation therapyBreast cancerSide effectsAdjuvant radiation therapyBreast cancer careBreast cancer survivorsCancer survivorsMean ageCancer careCancer needsResponse rateProfessional Advisory CommitteeTherapyWomenCancerAdvisory CommitteeParticipantsYearsWide variationLumpectomyMain decision makers
2016
Preoperative breast magnetic resonance imaging and contralateral breast cancer occurrence among older women with ductal carcinoma in situ
Wang SY, Long JB, Killelea BK, Evans SB, Roberts KB, Silber A, Gross CP. Preoperative breast magnetic resonance imaging and contralateral breast cancer occurrence among older women with ductal carcinoma in situ. Breast Cancer Research And Treatment 2016, 158: 139-148. PMID: 27287780, PMCID: PMC5554869, DOI: 10.1007/s10549-016-3858-0.Peer-Reviewed Original ResearchConceptsContralateral breast cancerMagnetic resonance imagingPreoperative magnetic resonance imagingDuctal carcinomaMRI usePreoperative breast magnetic resonance imagingEnd Results-Medicare datasetInvasive contralateral breast cancerOccult contralateral breast cancerResonance imagingSynchronous contralateral breast cancerImpact of MRIStage-specific incidence ratesPreoperative MRI useBreast magnetic resonance imagingBreast cancer occurrenceCBC eventsCBC ratesCumulative incidencePropensity score approachIncidence rateInvasive diseaseBreast cancerCancer occurrenceOlder women
2015
Preoperative Breast Magnetic Resonance Imaging and Contralateral Breast Cancer Occurrence Among Older Women With Breast Cancer
Wang SY, Long JB, Killelea BK, Evans SB, Roberts KB, Silber A, Gross CP. Preoperative Breast Magnetic Resonance Imaging and Contralateral Breast Cancer Occurrence Among Older Women With Breast Cancer. Journal Of Clinical Oncology 2015, 34: 321-328. PMID: 26628465, PMCID: PMC4872032, DOI: 10.1200/jco.2015.62.9741.Peer-Reviewed Original ResearchConceptsContralateral breast cancerPreoperative magnetic resonance imagingMagnetic resonance imagingBreast cancerCBC eventsMRI useOlder womenPreoperative breast magnetic resonance imagingOccult contralateral breast cancerResonance imagingStage IIEarly-stage breast cancerPreoperative MRI useBreast magnetic resonance imagingBreast cancer occurrenceSEER-Medicare databaseImpact of detectionDetection rateCumulative incidenceCancer occurrenceStage ICancerPropensity scoreWomenPatientsRacial Differences in the Use and Outcome of Neoadjuvant Chemotherapy for Breast Cancer: Results From the National Cancer Data Base
Killelea BK, Yang VQ, Wang SY, Hayse B, Mougalian S, Horowitz NR, Chagpar AB, Pusztai L, Lannin DR. Racial Differences in the Use and Outcome of Neoadjuvant Chemotherapy for Breast Cancer: Results From the National Cancer Data Base. Journal Of Clinical Oncology 2015, 33: 4267-4276. PMID: 26598753, DOI: 10.1200/jco.2015.63.7801.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAntineoplastic Combined Chemotherapy ProtocolsAsianBiomarkers, TumorBlack or African AmericanBreast NeoplasmsCarcinoma, Ductal, BreastCarcinoma, LobularChemotherapy, AdjuvantComorbidityDatabases, FactualFemaleHispanic or LatinoHumansInsurance CoverageInsurance, HealthMiddle AgedNeoadjuvant TherapyNeoplasm GradingNeoplasm StagingReceptor, ErbB-2Receptors, EstrogenReceptors, ProgesteroneTreatment OutcomeTriple Negative Breast NeoplasmsUnited StatesWhite PeopleConceptsPathologic complete responseNational Cancer Data BaseNeoadjuvant chemotherapyBreast cancerEstrogen receptorWhite womenPositive tumorsAsian womenHuman epidermal growth factor receptor 2HER2-positive breast cancerEpidermal growth factor receptor 2Timing of chemotherapyClinical T stageGrowth factor receptor 2Triple-negative tumorsPatient's zip codeHigh-grade tumorsRacial differencesZip codesFactor receptor 2Chemotherapy useComorbidity indexComplete responseT stageGrade tumorsThe Role of Patient Factors, Cancer Characteristics, and Treatment Patterns in the Cost of Care for Medicare Beneficiaries with Breast Cancer
Xu X, Herrin J, Soulos PR, Saraf A, Roberts KB, Killelea BK, Wang SY, Long JB, Wang R, Ma X, Gross CP. The Role of Patient Factors, Cancer Characteristics, and Treatment Patterns in the Cost of Care for Medicare Beneficiaries with Breast Cancer. Health Services Research 2015, 51: 167-186. PMID: 26119176, PMCID: PMC4722219, DOI: 10.1111/1475-6773.12328.Peer-Reviewed Original ResearchConceptsBreast cancer careHospital referral regionsCancer careMedicare expendituresBreast cancerRadiation therapyTreatment factorsMean Medicare expendituresEnd Results-MedicareSpecific treatment modalitiesContribution of patientCost of careHighest spending quintilePatient factorsTreatment patternsTumor characteristicsCancer characteristicsTreatment modalitiesReferral regionsMedicare beneficiariesQuintilePatientsCancerCareTherapy
2014
Cardiovascular events, early discontinuation of trastuzumab, and their impact on survival
Wang SY, Long JB, Hurria A, Owusu C, Steingart RM, Gross CP, Chen J. Cardiovascular events, early discontinuation of trastuzumab, and their impact on survival. Breast Cancer Research And Treatment 2014, 146: 411-419. PMID: 24951268, DOI: 10.1007/s10549-014-3029-0.Peer-Reviewed Original ResearchConceptsCardiovascular eventsEarly discontinuationTrastuzumab treatmentCause mortalityTrastuzumab therapyTrastuzumab discontinuationBreast cancerCox proportional hazards modelContinuous trastuzumab treatmentAdverse cardiovascular eventsPopulation-based cohortFemale Medicare beneficiariesHigher mortality riskProportional hazards modelNon-significant increaseCardiovascular complicationsOlder patientsOverall survivalHeart failureAtrial fibrillationDiscontinuationMortality riskOlder womenMedicare beneficiariesHazards modelExamining the Cost-Effectiveness of Radiation Therapy Among Older Women With Favorable-Risk Breast Cancer
Sen S, Wang SY, Soulos PR, Frick KD, Long JB, Roberts KB, Yu JB, Evans SB, Chagpar AB, Gross CP. Examining the Cost-Effectiveness of Radiation Therapy Among Older Women With Favorable-Risk Breast Cancer. Journal Of The National Cancer Institute 2014, 106: dju008. PMID: 24598714, PMCID: PMC3982782, DOI: 10.1093/jnci/dju008.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBrachytherapyBreast NeoplasmsComorbidityCost-Benefit AnalysisFemaleHealth ExpendituresHumansLife ExpectancyMedicareNeoplasm Recurrence, LocalNeoplasm StagingQuality of LifeQuality-Adjusted Life YearsRadiotherapy, Intensity-ModulatedRisk AssessmentRisk FactorsSampling StudiesSEER ProgramUnited StatesConceptsExternal beam radiation therapyIncremental cost-effectiveness ratioQuality-adjusted life yearsBreast cancerOlder womenRadiation therapyEnd Results-Medicare databaseRisk breast cancerBeam radiation therapyCost-effectiveness ratioNewer radiation therapy modalitiesQuality of lifeRadiation therapy modalitiesLocal recurrenceTrial criteriaRT modalityTherapy modalitiesLife yearsCancerIncremental costTherapyWomenBaseline stateNew modality
2013
The association of preoperative breast magnetic resonance imaging and multiple breast surgeries among older women with early stage breast cancer
Wang SY, Kuntz KM, Tuttle TM, Jacobs DR, Kane RL, Virnig BA. The association of preoperative breast magnetic resonance imaging and multiple breast surgeries among older women with early stage breast cancer. Breast Cancer Research And Treatment 2013, 138: 137-147. PMID: 23354364, DOI: 10.1007/s10549-013-2420-6.Peer-Reviewed Original ResearchConceptsEarly-stage breast cancerStage breast cancerMultiple surgeriesPreoperative breast MRIBreast cancerAdditional surgeryBreast surgeryPreoperative breast magnetic resonance imagingEnd Results-Medicare databaseBreast MRIInitial treatment episodeMore additional surgeriesPhysician-level predictorsBreast magnetic resonance imagingMagnetic resonance imaging (MRI) utilizationInitial treatment periodMultilevel logistic regression modelsMedian odds ratioMagnetic resonance imagingLogistic regression modelsPrimary surgeryTumor characteristicsMRI evaluationPartial mastectomyTreatment episodes
2012
Ductal carcinoma in situ, and the influence of the mode of detection, population characteristics, and other risk factors.
Virnig BA, Wang SY, Tuttle TM. Ductal carcinoma in situ, and the influence of the mode of detection, population characteristics, and other risk factors. American Society Of Clinical Oncology Educational Book 2012, 45-8. PMID: 24451706, DOI: 10.14694/edbook_am.2012.32.81.Peer-Reviewed Original ResearchInvasive breast cancerMajor risk factorBreast cancerRisk factorsEndocrine therapyDuctal carcinomaSentinel lymph node biopsyRate of DCISTreatment of DCISLymph node biopsyProgesterone receptor statusWhole breast irradiationRisk of overtreatmentPartial breast irradiationNormal breast tissueDCIS recurrenceHER2 positivityNode biopsyPrognostic factorsReceptor statusInvasive diseaseObservational studyTreatment decisionsDCISCancer