Hanxi “Molly” Zhang
Neoadjuvant Versus Adjuvant Chemotherapy for Older Adults with Stage I-III Breast Cancer
Summary
Despite an increasing trend of neoadjuvant chemotherapy (NAC) use in breast cancer, evidence on benefits/risks of NAC — specifically in older women and within cancer subtypes – is limited, possibly contributing to the sizable variation in NAC use. This project aims to examine the effect of NAC versus adjuvant chemotherapy (AdC) alone on survival, health care utilization, and costs, in addition to assessing the temporal trends of NAC use and identifying factors related to NAC use among older women. The project will use the population-based Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database to identify stage I-III breast-cancer patients. Subtype heterogeneity will be incorporated throughout, and propensity score matching is proposed to reduce bias. The research is expected to provide otherwise unavailable evidence on NAC in a large elderly population, which will inform patient-physician decision making and ultimately improve clinical and economic outcomes.
It is incredibly motivating to have received this recognition of my potential as I strive to become an independent and productive health outcomes researcher.
