caa a22 4500 445335866 CHVBK 20180317142754.0 cr unu---uuuuu 170323e20110401xx s 000 0 eng 10.1245/s10434-010-1487-0 doi (NATIONALLICENCE)springer-10.1245/s10434-010-1487-0 Alternative Therapy Used as Primary Treatment for Breast Cancer Negatively Impacts Outcomes [Elektronische Daten] [Esther Han, Nathalie Johnson, Tammy DelaMelena, Margaret Glissmeyer, Kari Steinbock] Background: The use of complementary and alternative medicine (CAM) has escalated over the past decade, despite the fact that clinical studies validating the efficacy of CAM remain sparse. Clinicians frequently encounter patients who reject standard treatment, but data on outcomes of patients choosing CAM as primary treatment for breast cancer are also lacking. Materials and Methods: Breast cancer patients who refused/delayed standard treatments in favor of alternative therapies were identified in a community surgical practice over a 10-year period. A retrospective chart review was performed with telephone interviews when possible. Estimated 10-year survival given recommended treatment was calculated. Results: A total of 61 patients was identified; median age was 53. Median follow-up was 54months. Patients were stratified into 2 subgroups: those who omitted/delayed surgery (SSG, n=26) and those who were nonadherent to adjuvant therapy recommendations (ASG, n=35). In the SSG, 96.2% experienced disease progression; 50% died of disease. Mean stage at initial presentation was II; mean stage at re-presentation after primary treatment with alternative therapies was IV. Disease progression occurred in 86.2% of those in the ASG; 20% died of disease. The mean 10-year survival calculated for those omitting surgery was 69.5%; observed survival for this group was 36.4% at a median follow-up of 33months. Conclusions: Alternative therapies used as primary treatment for breast cancer are associated with disease progression and increased risk of recurrence and death. Diminished outcomes are more profound in those delaying/omitting surgery. Reviewing these results with our patients may help bridge the gap between CAM and standard treatments. Society of Surgical Oncology, 2011 Han Esther Oregon Health & Science University, Portland, OR, USA aut Johnson Nathalie Legacy Health System, Cancer Services, Portland, OR, USA aut DelaMelena Tammy Legacy Health System, Cancer Services, Portland, OR, USA aut Glissmeyer Margaret Legacy Health System, Cancer Services, Portland, OR, USA aut Steinbock Kari Legacy Health System, Cancer Services, Portland, OR, USA aut Annals of Surgical Oncology Springer-Verlag 18/4(2011-04-01), 912-916 1068-9265 18:4<912 2011 18 10434 https://doi.org/10.1245/s10434-010-1487-0 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1487-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Han Esther Oregon Health & Science University, Portland, OR, USA aut NATIONALLICENCE 700 1- Johnson Nathalie Legacy Health System, Cancer Services, Portland, OR, USA aut NATIONALLICENCE 700 1- DelaMelena Tammy Legacy Health System, Cancer Services, Portland, OR, USA aut NATIONALLICENCE 700 1- Glissmeyer Margaret Legacy Health System, Cancer Services, Portland, OR, USA aut NATIONALLICENCE 700 1- Steinbock Kari Legacy Health System, Cancer Services, Portland, OR, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/4(2011-04-01), 912-916 1068-9265 18:4<912 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer