Real‐World Practice Patterns in Diagnosis and First‐Line Treatment in Metastatic Breast Cancer.

Intro: Divergence from national guidelines and variations in practice patterns impact care and outcomes in patients with metastatic breast cancer (MBC). We sought to assess the quality of care in the diagnosis and treatment of real‐world patients with MBC in Washington State. Methods: Data were retr...

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Published in:Breast Journal Vol. 2026; pp. 1 - 10
Main Authors: Manohar, Poorni M., Shankaran, Veena, Davidson, Nancy E., Hunter, Natasha, Gwin, William R., Yung, Rachel L., Specht, Jennifer M., Federenko, Catherine, Qin, Sun, Wu, Qian, Voustinas, Jenna M., Roth, Josh A., Linden, Hannah M., Wesley, Hannah
Format: research tables/charts Journal Article
Published: Wiley-Blackwell 6/28/2026
Online Access:View this record in EBSCOhost
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      dt: 6/28/2026
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1155/tbj/4333748
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        atl: Real‐World Practice Patterns in Diagnosis and First‐Line Treatment in Metastatic Breast Cancer.
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          Manohar, Poorni M.
          Shankaran, Veena
          Davidson, Nancy E.
          Hunter, Natasha
          Gwin, William R.
          Yung, Rachel L.
          Specht, Jennifer M.
          Federenko, Catherine
          Qin, Sun
          Wu, Qian
          Voustinas, Jenna M.
          Roth, Josh A.
          Linden, Hannah M.
          Wesley, Hannah
        affil: Department of Internal Medicine,, Rush University Medical Center,, Chicago, Illinois, USA, rush.edu
      sug:
        subj:
          Breast Neoplasms Diagnosis
          Breast Neoplasms Therapy
          Neoplasm Metastasis
          Guideline Adherence
          Human
          Funding Source
          Female
          Aged
          Retrospective Design
          Descriptive Statistics
          Data Analysis Software
          Kruskal-Wallis Test
          Fisher's Exact Test
          Comparative Studies
          Receptors, Estrogen
          Tumor Markers, Biological
          Immunohistochemistry
          Biopsy
          Cost Benefit Analysis
          Aged: 65+ years
          Female
      ab: Intro: Divergence from national guidelines and variations in practice patterns impact care and outcomes in patients with metastatic breast cancer (MBC). We sought to assess the quality of care in the diagnosis and treatment of real‐world patients with MBC in Washington State. Methods: Data were retrospectively analyzed using a linked cancer registry and insurance claims platform for patients with recurrent or de novo MBC diagnosed between 2008 and 2019. Results: We identified 1101 patients with MBC (median age: 66), 715 recurrent and 386 de novo. Most patients were White (89%), all were insured (Commercial [47%], Medicaid [4%], Medicare [35%], or multiple [13%]), and 15% lived in areas of high deprivation (Area Deprivation Index [ADI]: 8–10). Of the patients with recurrent MBC, less than half received a biopsy (49.5%) or biomarker reassessment (48.7%) to confirm the diagnosis of MBC. Patients treated at high‐ and medium‐volume centers had higher rates of biopsy than low‐volume clinics (51.9%, 54.3%, and 40.7%, respectively, p = 0.03). ET alone was more common in patients who did not undergo biopsy (62.3% vs. 37.7%, p < 0.001) or biomarker reassessment (62.7% vs. 37.3%, p < 0.001). Among the 677 patients with estrogen receptor (ER)+/HER2− MBC (de novo and recurrent), most received ET alone (69%), followed by CT (22%) and CDKi + ET (9%). Importantly, 40% of patients were treated before CDK4/6i approval. Most patients who received CDKi + ET were < 65 years old (65.2%, p < 0.02). Patients with commercial insurance were more likely to receive CDKi + ET compared to those with Medicare/Medicaid. (60.9% vs. 26.1%, p = 0.10). Conclusion: Our findings highlight key gaps in MBC management and serve as a launch point for patient‐centered and quality‐promoting initiatives.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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