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...
| Published in: | Breast Journal Vol. 2026; pp. 1 - 10 |
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| Main Authors: | , , , , , , , , , , , , , |
| Format: | research tables/charts Journal Article |
| Published: |
Wiley-Blackwell
6/28/2026
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=194947009&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 194947009 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 1075122X ET6 jtl: Breast Journal issn: 1075122X maglogo: Y pubinfo: dt: 6/28/2026 vid: 2026 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 194947009 194947009 194947009 10.1155/tbj/4333748 194947009 ppf: 1 ppct: 9 formats: fmt: – @attributes: type: T – @attributes: type: C – @attributes: type: P tig: atl: Real‐World Practice Patterns in Diagnosis and First‐Line Treatment in Metastatic Breast Cancer. aug: au: 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 refInfo: holdings: @attributes: islocal: N |
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