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71.

Introduction

The 21-gene recurrence score (RS) (Oncotype Dx, Genomic Health, Redwood City Ca) has not been validated in an older cohort with estrogen receptor (ER)-positive breast cancer. The objective of this study was to evaluate RS validity in a group of older women with ER-positive breast cancer.

Methods

Utilizing the Surveillance, Epidemiology, and End Results Program (SEER) database with available RS, we evaluated women with ER-positive breast cancer aged 18–69 and those 70?years of age and older from 2004 to 2014. We utilized multivariable logistic regression models to evaluate factors associated with RS testing as well as a high-risk categorization for those who underwent testing. Survival was analyzed using Kaplan Meier curves and Cox proportional hazard models.

Results

We identified 363,876 women aged 18–69?years and 147,107 women aged 70?years and older. A smaller proportion of patients in the older group (8%) underwent RS testing than in the younger group (18%). Of the patients who underwent testing, distribution of RS was similar between groups. High-risk categorization independently predicted a higher likelihood of death for older patients (hazard ratio 1.47, 95% confidence interval 1.15–1.90). Among patients with high-risk RS, chemotherapy was associated with a decreased risk of death in the younger group, but not in the older group.

Conclusion

Older women are less likely to receive RS testing, but when tested, older patients have a similar distribution of RS as compared to younger patients. While high-risk categorization in the older cohort was prognostic, chemotherapy was not associated with improved survival.  相似文献   
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The above article from Journal of Advanced Nursing, published online on 26th June 2014 in Wiley Online Library ( wileyonlinelibrary.com ) has been retracted by agreement between the journal Editor‐in‐Chief and John Wiley & Sons Ltd. The retraction has been agreed due to considerable overlap with the following papers: Zhu L.‐X., Ho S.‐C., Sit J.W.H., He H.‐G. (2014) Effect of a transtheoretical model‐based stage‐matched exercise intervention on exercise behavior and angina in patients with coronary heart disease: a randomized controlled trial. Journal of Cardiovascular Nursing DOI: 10.1097/JCN.0000000000000162 . Zhu L.‐X., Ho S.‐C., Sit J.W.H., He H.‐G. (2014) The effects of a transtheoretical model‐based exercise stage‐matched intervention on exercise behavior in patients with coronary heart disease: A randomized controlled trial. Patient Education and Counseling 95, 384–392. Reference Zhu L‐X., Ho S‐C., Sit J.W.H. & He H‐G. (2014) Effects of a transtheoretical model–based exercise stage–matched intervention on exercise behaviour and quality of life in patients with coronary heart disease: a randomized controlled trial. Journal of Advanced Nursing. doi: 10.1111/jan.12469  相似文献   
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A 7‐day‐old male infant with membranous pulmonary atresia and intact ventricular septum (PA/IVS) underwent hybrid pulmonary valvotomy. Access was via median sternotomy guided by intra‐operative epicardial ultrasonography. After puncturing the atretic pulmonary valve, a 6 mm Wanda balloon catheter was inflated to dilate the atretic valve. Adequate valve movement with antegrade flow was confirmed using real time epicardial echocardiography. Intra‐operative epicardial ultrasonography is an effective tool for guiding PA/IVS during hybrid procedures. Epicardial echo imaging provides clear images with excellent quality, helps guide the hybrid operation, and prevents the need for the ionizing radiation of fluoroscopy.  相似文献   
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