Abstract P4-14-03: Stage-specific survival of breast cancer patients receiving alternative medicine for treatment of cancer

Background: We previously reported on the decreased survival in cancer patients associated with alternative medicine (AM). There is limited information on incidence and stage-specific survival outcomes of breast cancer patients who receive AM compared to those who receive conventional cancer treatment (CCT). Methods: Patients diagnosed with breast cancer in 2004-2016 were identified using the National Cancer Database. Patients were excluded if they had multiple malignant primaries, had radiation to a site other than breast, had unknown treatment status, received palliative care, or had missing death, estrogen receptor (ER), progesterone receptor (PR), and/or clinical stage information. Those who received an unproven cancer treatment and did not receive any CCT, defined as surgery, radiotherapy, chemotherapy, and/or hormone therapy, were classified within the AM group. Annual cumulative incidence of AM was assessed and differences by year were analyzed by the Cochran-Armitage test. Treatment selection was evaluated by the chi-square test, t-test, and logistic regression. Following 2:1 matching on age, clinical group stage, Charlson-Deyo comorbidity score (CDCS), insurance type, race, and year of diagnosis, overall and stage-specific survival were analyzed using the Kaplan-Meier method, log-rank test, and Cox proportional hazards regression for early stage (clinical stages I and II), locally advanced stage (clinical stage III), and metastatic disease (clinical stage IV).Variables with a p-value of ≤ 0.1 on univariate analyses were selected for entry into multivariable Cox proportional hazards survival modeling. Results: We identified 139 patients with breast cancer who received AM. The annual cumulative incidence of AM varied widely by year with increasing use from 10.8/100,000 in 2012 to 20.5/100,000 in 2015. Use of AM from 2004 to 2015 did not significantly increase. On multivariable analysis, when controlling for demographic and clinical factors, those residing in a non-metropolitan county compared to a metropolitan country (Odds Ratio [OR] = .42, 95% Confidence Interval [CI] = .17 to .99) and those with a CDCS of 1 compared to 0 (OR = .33, 95% CI = .12 to .91) were less likely to receive AM; those receiving care in a Pacific location compared to a Northeast location (OR = 5.57, 95% CI = 2.61 to 11.88) and those with a clinical stage of 4 compared to 1 (OR = 6.53, 95% CI = 3.30 to 12.94) were more likely to receive AM. Following matching, there were no significant differences between matched characteristics (all p>0.9). On matched univariate survival analysis, AM was associated with worse 5-year survival compared to CCT in the overall group (54% vs 82%, p Citation Format: Huaqi Li, James B Yu, Cary P Gross, Henry S Park, Skyler B Johnson. Stage-specific survival of breast cancer patients receiving alternative medicine for treatment of cancer [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P4-14-03.