Evaluation of Surgical Disparities Between African American and European American Women Treated for Breast Cancer Within an Equal-Access Military Hospital

Leann A. Lovejoy, Yvonne L. Eaglehouse, Matthew Timothy Hueman, Bradley J. Mostoller, Craig D. Shriver, Rachel E. Ellsworth

Research output: Contribution to journalArticle

Abstract

Background: Survival disparities between African American women (AAW) and European American women (EAW) with invasive breast cancer may be attributable, in part, to access to or quality of medical care. In this study, we evaluated surgical disparities between AAW and EAW treated within an equal-access military treatment facility (MTF). Methods: All AAW (N = 271) and EAW (N = 628) with Stage I–III breast cancer who had their initial diagnosis performed at Murtha Cancer Center at Walter Reed National Military Medical Center were identified. Differences in surgical interval (time between diagnosis and definitive breast surgery) and surgical procedures were evaluated using χ2 and Student t-tests while survival was analyzed using Kaplan–Meier survival estimates and log-rank tests. A P value < 0.05 was used to define significance. Results: Surgical intervals did not differ significantly between populations with an average of 36.3 days in AAW and 33.9 days in EAW. Frequency of the percentage of women undergoing reexcision, mastectomy, and prophylactic removal of the contralateral breast did not differ significantly between populations. Likewise, frequency of sentinel lymph node biopsy and 5-year survival were not significantly different between AAW compared to EAW. Discussion: Surgical intervals and procedures were similar between AAW and EAW treated within an equal-access MTF. These data demonstrate that the availability of quality surgical care to all patients with stage I–III breast cancer may eliminate survival disparities between AAW and EAW, emphasizing the importance of equalizing access to breast care.

Original languageEnglish (US)
JournalAnnals of Surgical Oncology
DOIs
StateAccepted/In press - Jan 1 2019

Fingerprint

Military Hospitals
African Americans
Breast Neoplasms
Military Facilities
Survival
Breast
Quality of Health Care
Sentinel Lymph Node Biopsy

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Evaluation of Surgical Disparities Between African American and European American Women Treated for Breast Cancer Within an Equal-Access Military Hospital. / Lovejoy, Leann A.; Eaglehouse, Yvonne L.; Hueman, Matthew Timothy; Mostoller, Bradley J.; Shriver, Craig D.; Ellsworth, Rachel E.

In: Annals of Surgical Oncology, 01.01.2019.

Research output: Contribution to journalArticle

@article{cb982d78e18549999cb8189e1495241c,
title = "Evaluation of Surgical Disparities Between African American and European American Women Treated for Breast Cancer Within an Equal-Access Military Hospital",
abstract = "Background: Survival disparities between African American women (AAW) and European American women (EAW) with invasive breast cancer may be attributable, in part, to access to or quality of medical care. In this study, we evaluated surgical disparities between AAW and EAW treated within an equal-access military treatment facility (MTF). Methods: All AAW (N = 271) and EAW (N = 628) with Stage I–III breast cancer who had their initial diagnosis performed at Murtha Cancer Center at Walter Reed National Military Medical Center were identified. Differences in surgical interval (time between diagnosis and definitive breast surgery) and surgical procedures were evaluated using χ2 and Student t-tests while survival was analyzed using Kaplan–Meier survival estimates and log-rank tests. A P value < 0.05 was used to define significance. Results: Surgical intervals did not differ significantly between populations with an average of 36.3 days in AAW and 33.9 days in EAW. Frequency of the percentage of women undergoing reexcision, mastectomy, and prophylactic removal of the contralateral breast did not differ significantly between populations. Likewise, frequency of sentinel lymph node biopsy and 5-year survival were not significantly different between AAW compared to EAW. Discussion: Surgical intervals and procedures were similar between AAW and EAW treated within an equal-access MTF. These data demonstrate that the availability of quality surgical care to all patients with stage I–III breast cancer may eliminate survival disparities between AAW and EAW, emphasizing the importance of equalizing access to breast care.",
author = "Lovejoy, {Leann A.} and Eaglehouse, {Yvonne L.} and Hueman, {Matthew Timothy} and Mostoller, {Bradley J.} and Shriver, {Craig D.} and Ellsworth, {Rachel E.}",
year = "2019",
month = "1",
day = "1",
doi = "10.1245/s10434-019-07706-z",
language = "English (US)",
journal = "Annals of Surgical Oncology",
issn = "1068-9265",
publisher = "Springer New York",

}

TY - JOUR

T1 - Evaluation of Surgical Disparities Between African American and European American Women Treated for Breast Cancer Within an Equal-Access Military Hospital

AU - Lovejoy, Leann A.

AU - Eaglehouse, Yvonne L.

AU - Hueman, Matthew Timothy

AU - Mostoller, Bradley J.

AU - Shriver, Craig D.

AU - Ellsworth, Rachel E.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Survival disparities between African American women (AAW) and European American women (EAW) with invasive breast cancer may be attributable, in part, to access to or quality of medical care. In this study, we evaluated surgical disparities between AAW and EAW treated within an equal-access military treatment facility (MTF). Methods: All AAW (N = 271) and EAW (N = 628) with Stage I–III breast cancer who had their initial diagnosis performed at Murtha Cancer Center at Walter Reed National Military Medical Center were identified. Differences in surgical interval (time between diagnosis and definitive breast surgery) and surgical procedures were evaluated using χ2 and Student t-tests while survival was analyzed using Kaplan–Meier survival estimates and log-rank tests. A P value < 0.05 was used to define significance. Results: Surgical intervals did not differ significantly between populations with an average of 36.3 days in AAW and 33.9 days in EAW. Frequency of the percentage of women undergoing reexcision, mastectomy, and prophylactic removal of the contralateral breast did not differ significantly between populations. Likewise, frequency of sentinel lymph node biopsy and 5-year survival were not significantly different between AAW compared to EAW. Discussion: Surgical intervals and procedures were similar between AAW and EAW treated within an equal-access MTF. These data demonstrate that the availability of quality surgical care to all patients with stage I–III breast cancer may eliminate survival disparities between AAW and EAW, emphasizing the importance of equalizing access to breast care.

AB - Background: Survival disparities between African American women (AAW) and European American women (EAW) with invasive breast cancer may be attributable, in part, to access to or quality of medical care. In this study, we evaluated surgical disparities between AAW and EAW treated within an equal-access military treatment facility (MTF). Methods: All AAW (N = 271) and EAW (N = 628) with Stage I–III breast cancer who had their initial diagnosis performed at Murtha Cancer Center at Walter Reed National Military Medical Center were identified. Differences in surgical interval (time between diagnosis and definitive breast surgery) and surgical procedures were evaluated using χ2 and Student t-tests while survival was analyzed using Kaplan–Meier survival estimates and log-rank tests. A P value < 0.05 was used to define significance. Results: Surgical intervals did not differ significantly between populations with an average of 36.3 days in AAW and 33.9 days in EAW. Frequency of the percentage of women undergoing reexcision, mastectomy, and prophylactic removal of the contralateral breast did not differ significantly between populations. Likewise, frequency of sentinel lymph node biopsy and 5-year survival were not significantly different between AAW compared to EAW. Discussion: Surgical intervals and procedures were similar between AAW and EAW treated within an equal-access MTF. These data demonstrate that the availability of quality surgical care to all patients with stage I–III breast cancer may eliminate survival disparities between AAW and EAW, emphasizing the importance of equalizing access to breast care.

UR - http://www.scopus.com/inward/record.url?scp=85070853912&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85070853912&partnerID=8YFLogxK

U2 - 10.1245/s10434-019-07706-z

DO - 10.1245/s10434-019-07706-z

M3 - Article

JO - Annals of Surgical Oncology

JF - Annals of Surgical Oncology

SN - 1068-9265

ER -