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01.12.2012 | Research | Ausgabe 1/2012 Open Access

World Journal of Surgical Oncology 1/2012

Outcome analysis of breast cancer patients who declined evidence-based treatment

World Journal of Surgical Oncology > Ausgabe 1/2012
Kurian Joseph, Sebastian Vrouwe, Anmmd Kamruzzaman, Ali Balbaid, David Fenton, Richard Berendt, Edward Yu, Patricia Tai
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1477-7819-10-118) contains supplementary material, which is available to authorized users.

Competing interest

The authors indicated no potential conflicts of interest.

Authors’ contributions

Conception and design: KJ, SV, PT. Administrative support: KJ, SV, AK, AB. Provision of study materials or patients: KJ, SV, AK. Collection and assembly of data: SV, AK. Data analysis and interpretation: KJ, AK, PT. Manuscript writing: KJ, SV, AK. Review of manuscript: DF, PT, RB, EY. Final approval of manuscript: KJ, SV, AK, AB, DF, PT, RB, EY. All authors read and approved the final manuscript.
This project was supported by the Health Quality Council of Alberta (HQCA). Partly presented at the annual CARO meeting 2011, Winnipeg, Manitoba, Canada.



To analyze the characteristics and outcomes of women with breast cancer in the Northern Alberta Health Region (NAHR) who declined recommended primary standard treatments.


A chart review was performed of breast cancer patients who refused recommended treatments during the period 1980 to 2006. A matched pair analysis was performed to compare the survival data between those who refused or received standard treatments.


A total of 185 (1.2%) patients refused standard treatment. Eighty-seven (47%) were below the age of 75 at diagnosis. The majority of those who refused standard treatments were married (50.6%), 50 years or older (60.9%), and from the urban area (65.5%). The 5-year overall survival rates were 43.2% (95% CI: 32.0 to 54.4%) for those who refused standard treatments and 81.9% (95% CI: 76.9 to 86.9%) for those who received them. The corresponding values for the disease-specific survival were 46.2% (95% CI: 34.9 to 57.6%) vs. 84.7% (95% CI: 80.0 to 89.4%).


Women who declined primary standard treatment had significantly worse survival than those who received standard treatments. There is no evidence to support using Complementary and Alternative Medicine (CAM) as primary cancer treatment.
Authors’ original file for figure 1
Authors’ original file for figure 2
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