Publications by authors named "Young Chandler"
Background: Extending endocrine therapy from 5 to 10 years is recommended for women with invasive estrogen receptor (ER)-positive breast cancers. We evaluated the benefits and harms of the five additional years of therapy.
Methods: An established Cancer Intervention and Surveillance Network (CISNET) model used a lifetime horizon with national and clinical trial data on treatment efficacy and adverse events and other-cause mortality among multiple birth cohorts of U.
Article Synopsis
- There is a need for a flexible decision-making tool that incorporates various clinical and genomic factors for women with early-stage breast cancer, specifically those with certain hormone receptor status and no lymph node involvement.
- The study utilized a simulation model to analyze the 10-year risks and benefits of chemoendocrine versus endocrine therapy for different patient subgroups, focusing on various characteristics like age, tumor size, and comorbidities.
- The findings suggest that for certain patients, the choice of therapy has minimal effects on long-term outcomes, and the model can be used to assess treatment options and genomic testing effectively.
Background: Tumor genomic expression profile data are used to guide chemotherapy choice, but there are gaps in evidence for women aged 65 years and older. We estimate chemotherapy effects by age and comorbidity level among women with early-stage, hormone receptor-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancers and Oncotype DX scores of 26 or higher.
Methods: A discrete-time stochastic state transition simulation model synthesized data from population studies and clinical trials to estimate outcomes over a 25-year horizon for subgroups based on age (65-69, 70-74, 75-79, and 80-89 years) and comorbidity levels (no or low, moderate, severe).
Background: The Georgetown University-Albert Einstein College of Medicine breast cancer simulation model (Model GE) has evolved over time in structure and function to reflect advances in knowledge about breast cancer, improvements in early detection and treatment technology, and progress in computing resources. This article describes the model and provides examples of model applications.
Methods: The model is a discrete events microsimulation of single-life histories of women from multiple birth cohorts.
Importance: Given recent advances in screening mammography and adjuvant therapy (treatment), quantifying their separate and combined effects on US breast cancer mortality reductions by molecular subtype could guide future decisions to reduce disease burden.
Objective: To evaluate the contributions associated with screening and treatment to breast cancer mortality reductions by molecular subtype based on estrogen-receptor (ER) and human epidermal growth factor receptor 2 (ERBB2, formerly HER2 or HER2/neu).
Design, Setting, And Participants: Six Cancer Intervention and Surveillance Network (CISNET) models simulated US breast cancer mortality from 2000 to 2012 using national data on plain-film and digital mammography patterns and performance, dissemination and efficacy of ER/ERBB2-specific treatment, and competing mortality.
Purpose Gene expression profile (GEP) testing can support chemotherapy decision making for patients with early-stage, estrogen receptor-positive, human epidermal growth factor 2-negative breast cancers. This study evaluated the cost effectiveness of one GEP test, Onco type DX (Genomic Health, Redwood City, CA), in community practice with test-eligible patients age 40 to 79 years. Methods A simulation model compared 25-year societal incremental costs and quality-adjusted life-years (QALYs) of community Onco type DX use from 2005 to 2012 versus usual care in the pretesting era (2000 to 2004).
View Article and Find Full Text PDFCharacterization of arteriovenous identity in the developing neonate mouse retina.
Gene Expr Patterns
January 2017
Article Synopsis
- The murine retina serves as an effective model for studying blood vessel formation, specifically focusing on the differentiation and remodeling of arteries and veins.
- Researchers utilized techniques like in situ hybridization and immunofluorescent staining to investigate arteriovenous (AV) markers and how they develop in neonatal mice.
- Findings reveal that while the differentiation of arteries and veins begins around postnatal day 3, a clear molecular separation of vessel types is established by postnatal day 7, indicating a gradual process of AV identity acquisition during retinal development.
Background: Biennial screening is generally recommended for average-risk women aged 50 to 74 years, but tailored screening may provide greater benefits.
Objective: To estimate outcomes for various screening intervals after age 50 years based on breast density and risk for breast cancer.
Design: Collaborative simulation modeling using national incidence, breast density, and screening performance data.