Parity and disparity in first course treatment of invasive breast cancer

Mary Jo Lund, Otis Brawley, Kevin C. Ward, John L. Young, Sheryl S.G. Gabram, J. William Eley

Research output: Contribution to journalArticle

Abstract

Background: Adherence to first course treatment guidelines for breast cancer may not be uniform across racial/ethnic groups and could be a major contributing factor to disparities in outcome. In this population-based study, we assessed racial differences in initial treatment of breast cancer. Methods: Surveillance, Epidemiology, and End Results (SEER) program data were used to study all primary invasive breast cancers diagnosed during 2000-2001 among Black (n = 877) and White (n = 2437) female residents of the five Atlanta SEER counties, counties with several large teaching hospitals. Differences in treatment delay, cancer directed surgery, and receipt of chemotherapy, radiotherapy, or hormonal therapy were analyzed according to guidelines for treatment. Analyses utilized frequency distributions, χ2 tests of independence and statistics in and across strata. Results: Black women experienced longer treatment delays, regardless of stage at diagnosis, and were 4-5 fold more likely to experience delays greater than 60 days (P < 0.001). For local-regional disease, more Black women did not receive cancer directed surgery (7.5% vs. 1.5% of white women, P < 0.001), but did receive breast conserving surgery (BCS) equivalently. Only 61% of Black vs. 72% of White women received radiation with BCS (P < 0.001). Black women eligible for hormonal therapy were less likely to receive it (P < 0.001). Conclusion: Our findings suggest treatment standards are not adequately or equivalently met among Black and White women, even in an area where teaching hospitals provide a substantial portion of breast cancer care. Treatment differences can adversely affect outcome and reasons for the differences need to be addressed.

Original languageEnglish (US)
Pages (from-to)545-557
Number of pages13
JournalBreast Cancer Research and Treatment
Volume109
Issue number3
DOIs
StatePublished - Jun 1 2008
Externally publishedYes

Fingerprint

Parity
Breast Neoplasms
Therapeutics
Segmental Mastectomy
Teaching Hospitals
SEER Program
Guidelines
Ethnic Groups
Neoplasms
Epidemiology
Radiotherapy
Radiation
Drug Therapy
Population

Keywords

  • Breast neoplasms
  • Racial disparity
  • Treatment

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Parity and disparity in first course treatment of invasive breast cancer. / Lund, Mary Jo; Brawley, Otis; Ward, Kevin C.; Young, John L.; Gabram, Sheryl S.G.; Eley, J. William.

In: Breast Cancer Research and Treatment, Vol. 109, No. 3, 01.06.2008, p. 545-557.

Research output: Contribution to journalArticle

Lund, Mary Jo ; Brawley, Otis ; Ward, Kevin C. ; Young, John L. ; Gabram, Sheryl S.G. ; Eley, J. William. / Parity and disparity in first course treatment of invasive breast cancer. In: Breast Cancer Research and Treatment. 2008 ; Vol. 109, No. 3. pp. 545-557.
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