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Microsoft word - technical report #9 adjuvant usage trends.doc

Technical Report #9
Adjuvant Multi-agent
Chemotherapy and
Tamoxifen Usage Trends
for Breast Cancer in the
United States
Departments of Pathology1 and Surgery2, Massachusetts General Hospital and the Department of Pathology3, Harvard Medical School, Boston, Massachusetts Correspondence to James S. Michaelson Ph.D., Division of Surgical Oncology, Cox Building Room 626, Massachusetts General Hospital, 100 Blossom Street, Boston, Massachusetts, 02114 TEL 617 501 0590 FAX 617 724 3895 Email: The manuscripts available on our site are provided for your personal use only and may not be re-transmitted or redistributed without written permissions from the paper's publisher. You may quote this report as personal communication, after notifying Dr. James Michaelson PhD ( You may not upload any of this site's material to any public server, on-line service, or bulletin board without prior written permission from the publisher and authors. You may not make copies for any commercial purpose. Reproduction of materials retrieved from this web site is subject to the U.S. Copyright Act of 1976, Title 17 U.S.C. Overall Adjuvant Therapy Dissemination Trends
Mariotto et al.1 evaluated trends in the use of adjuvant multi-agent chemotherapy, tamoxifen, and the
combination of both treatments for early-stage breast cancer in the United States from 1975 through 1999. These trends were presented as a function of age and stage. To create a broader population-level estimate of the dissemination of adjuvant therapy in the United States, we took this data and aggregated them based upon appropriate yearly age and stage distributions found in the SEER registry. Weighted averages were then obtained for tamoxifen only, chemotherapy only, both, and the overall total adjuvant therapy usage trend. The appendix contains the details behind the calculations. 1 Mariotto A, Feuer EJ, Harlan LC, Wun LM, Johnson KA, Abrams J. Trends in Use of Adjuvant Multi-Agent Chemotherapy and Tamoxifen for Breast Cancer in the United States: 1975–1999. J Natl Cancer Inst 94: 1626-1634. APPENDIX
Age distribution in SEER by year:

Number of patients of each age group by year of diagnosis
Percentage of patients of each age group by year of diagnosis
Fraction treated for Stage II+/IIIA, weighted average based on age distribution:
Fraction treated for Stage II-, weighted average based on age distribution:
Figure 1.
Fraction treated for Stage I, weighted average based on age distribution:
Stage distribution in SEER by year:
Characteristics of tumor stages (as outlined by the AJCC) Stage I 2cm or less; 1-3 positive nodes or 2-5cm; node negati 2cm or less; >9 positive nodes or 2-5cm; 1 or more Number of patients in each stage group
Percentage of patients in each stage group
Weighted By Both Age and Stage:


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The nature of civilization

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