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Sharma N, Mehta TS, Wahab RA, Patel MM. Facilitating Culturally Competent Breast Imaging Care in South Asian Patients. JOURNAL OF BREAST IMAGING 2024:wbae026. [PMID: 38787594 DOI: 10.1093/jbi/wbae026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Indexed: 05/25/2024]
Abstract
South Asians are a rapidly growing subset of the Asian population in the United States. They comprise people from multiple countries with diverse beliefs, languages, and cultural identities and values. The incidence of breast cancer is rising in South Asian women in the United States, with earlier onset and predilection for HER2-enriched tumors. Despite the rising incidence of breast cancer, participation in screening remains lower than other populations. Health care inequities in South Asian women are multifactorial and may be due to traditional health beliefs and practices, language barriers, cultural differences, and lack of overall awareness. Developing a culturally sensitive environment in breast imaging clinic practice can lead to improved patient care and adherence. Given the scarcity of data specific to the South Asian population in United States, there is a need for health service researchers and practice leaders to obtain more high-quality data to understand the needs of South Asian patient populations.
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Affiliation(s)
- Nidhi Sharma
- Department of Radiology, Texas A&M University, Dallas, TX, USA
| | - Tejas S Mehta
- Department of Radiology, UMass Memorial Medical Center/UMass Chan Medical School, Worcester, MA, USA
| | - Rifat A Wahab
- Department of Radiology, University of Cincinnati Medical Center, Cincinnati, OH, USA
| | - Miral M Patel
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Chan DNS, Kwok C. Factors Influencing the Mammographic Screening Practices of South Asian Women in Hong Kong: A Qualitative Study. Cancer Nurs 2024:00002820-990000000-00218. [PMID: 38417126 DOI: 10.1097/ncc.0000000000001332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2024]
Abstract
BACKGROUND Breast cancer is a common type of cancer in South Asian women. Early detection by mammographic screening plays a significant role in improving survival rates. South Asian minorities in many countries have reported low mammographic screening rates. OBJECTIVE This study aimed to understand the factors that influence mammographic screening uptake among South Asian women in Hong Kong. METHODS This was a qualitative exploratory descriptive study. South Asian women 40 years or older with no history of breast cancer were recruited. In-depth face-to-face interviews were conducted following a semistructured interview guide. Thematic analysis was conducted to analyze the data. RESULTS A total of 31 South Asian women consented to participate. Among them, only 7 had ever undergone mammographic screening. The following themes of facilitating factors were identified: (1) influence of doctors, family, and friends; (2) strong sense of commitment to the family; and (3) accessibility and availability of mammographic screening information and services. The following themes for barriers to screening were identified: (1) beliefs about health management and social norms, (2) lack of knowledge and understanding of breast cancer and mammographic screening, (3) logistical barriers, and (4) physical barriers. CONCLUSION This study identified important facilitators and barriers that influence the uptake of mammographic screening among South Asian women in Hong Kong. IMPLICATIONS FOR PRACTICE The study findings can be used to guide the development and implementation of culturally relevant interventions to address barriers to screening, including the expected gender roles and responsibilities among women in their respective families.
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Affiliation(s)
- Dorothy Ngo Sheung Chan
- Author Affiliations: The Nethersole School of Nursing, The Chinese University of Hong Kong (Dr Chan), China; and School of Nursing, Paramedicine and Health Care Science, Faculty of Science and Health, Charles Sturt University, New South Wales (Dr Kwok), Australia
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Hashibe M, Wei M, Lee CJ, Tao R, Koric A, Wang J, Daud A, Tay D, Shen J, Lee YCA, Chang CPE. Incident Cardiovascular Disease Risk among Older Asian, Native Hawaiian and Pacific Islander Breast Cancer Survivors. Cancer Epidemiol Biomarkers Prev 2024; 33:126-135. [PMID: 37843411 PMCID: PMC10842246 DOI: 10.1158/1055-9965.epi-23-0679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 09/11/2023] [Accepted: 10/12/2023] [Indexed: 10/17/2023] Open
Abstract
BACKGROUND Cardiotoxicity among breast cancer survivors is associated with chemotherapy and radiation therapy. The risk of cardiovascular disease (CVD) among Asian, Native Hawaiian and Pacific Islander (ANHPI) breast cancer survivors in the United States is unknown. METHODS We used the SEER-Medicare linked database to estimate the risk of CVD among older breast cancer survivors. International Classification of Disease diagnosis codes were used to identify incident CVD outcomes. Cox proportional hazards models were used to estimate HRs and 95% confidence intervals (CI) comparing ANHPI with Non-Hispanic White (NHW) patients with breast cancer for CVD, and among ANHPI race and ethnicity groups. RESULTS A total of 7,122 ANHPI breast cancer survivors and 21,365 NHW breast cancer survivors were identified. The risks of incident heart failure and ischemic heart disease were lower among ANHPI compared with NHW breast cancer survivors (HRheart failure, 0.72; 95% CI, 0.61-0.84; HRheart disease, 0.74; 95% CI, 0.63-0.88). Compared with Japanese patients with breast cancer, Filipino, Asian Indian and Pakistani, and Native Hawaiian breast cancer survivors had higher risks of heart failure. ischemic heart disease and death. Among ANHPI breast cancer survivors, risk factors for heart failure included older age, higher comorbidity score, distant cancer stage and chemotherapy. CONCLUSIONS Our results support heterogeneity in CVD outcomes among breast cancer survivors among ANHPI race and ethnicity groups. Further research is needed to elucidate the disparities experienced among ANHPI breast cancer survivors. IMPACT Filipino, Asian Indian and Pakistani, and Native Hawaiian patients with breast cancer had higher risks of heart failure, ischemic heart disease and death among ANHPI patients with breast cancer.
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Affiliation(s)
- Mia Hashibe
- Huntsman Cancer Institute, Salt Lake City, Utah
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah
- Utah Cancer Registry, University of Utah, Salt Lake City, Utah
| | - Mei Wei
- Huntsman Cancer Institute, Salt Lake City, Utah
- Division of Oncology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah
| | - Catherine J. Lee
- Huntsman Cancer Institute, Salt Lake City, Utah
- Division of Hematology & Hematologic Malignancies, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah
| | - Randa Tao
- Huntsman Cancer Institute, Salt Lake City, Utah
- Department of Radiation Oncology, University of Utah School of Medicine, Salt Lake City, Utah
| | - Alzina Koric
- Huntsman Cancer Institute, Salt Lake City, Utah
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah
| | - Jing Wang
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah
| | - Anees Daud
- Division of Cardiovascular Medicine, University of Utah School of Medicine, Salt Lake City, Utah
| | - Djin Tay
- College of Nursing, University of Utah, Salt Lake City, Utah
| | - Jincheng Shen
- Division of Biostatistics, Department of Population Health Sciences, University of Utah School of Medicine, Salt Lake City, Utah
| | - Yuan-chin A. Lee
- Huntsman Cancer Institute, Salt Lake City, Utah
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah
| | - Chun-Pin E. Chang
- Huntsman Cancer Institute, Salt Lake City, Utah
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah
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Satagopan JM, Dharamdasani T, Mathur S, Kohler RE, Bandera EV, Kinney AY. Experiences and lessons learned from community-engaged recruitment for the South Asian breast cancer study in New Jersey during the COVID-19 pandemic. PLoS One 2023; 18:e0294170. [PMID: 37956167 PMCID: PMC10642833 DOI: 10.1371/journal.pone.0294170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 10/26/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND South Asians are a rapidly growing population in the United States. Breast cancer is a major concern among South Asian American women, who are an understudied population. We established the South Asian Breast Cancer (SABCa) study in New Jersey during early 2020 to gain insights into their breast cancer-related health attitudes. Shortly after we started planning for the study, the COVID-19 disease spread throughout the world. In this paper, we describe our experiences and lessons learned from recruiting study participants by partnering with New Jersey's community organizations during the COVID-19 pandemic. METHODS We used a cross-sectional design. We contacted 12 community organizations and 7 (58%) disseminated our study information. However, these organizations became considerably busy with pandemic-related needs. Therefore, we had to pivot to alternative recruitment strategies through community radio, Rutgers Cancer Institute of New Jersey's Community Outreach and Engagement Program, and Rutgers Cooperative Extension's community health programs. We recruited participants through these alternative strategies, obtained written informed consent, and collected demographic information using a structured survey. RESULTS Twenty five women expressed interest in the study, of which 22 (88%) participated. Nine (41%) participants learned about the study through the radio, 5 (23%) through these participants, 1 (4.5%) through a non-radio community organization, and 7 (32%) through community health programs. Two (9%) participants heard about the study from their spouse. All participants were born outside the US, their average age was 52.4 years (range: 39-72 years), and they have lived in the US for an average of 26 years (range: 5-51 years). CONCLUSION Pivoting to alternative strategies were crucial for successful recruitment. Findings suggest the significant potential of broadcast media for community-based recruitment. Family dynamics and the community's trust in our partners also encouraged participation. Such strategies must be considered when working with understudied populations.
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Affiliation(s)
- Jaya M. Satagopan
- Department of Biostatistics and Epidemiology, School of Public Health, Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States of America
| | - Tina Dharamdasani
- Department of Biostatistics and Epidemiology, School of Public Health, Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States of America
| | - Shailja Mathur
- Department of Family and Community Health Sciences, Cooperative Extension, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States of America
| | - Racquel E. Kohler
- Department of Health Behavior, Society & Policy, School of Public Health, Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States of America
| | - Elisa V. Bandera
- Cancer Epidemiology and Health Outcomes, Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States of America
| | - Anita Y. Kinney
- Department of Biostatistics and Epidemiology, School of Public Health, Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States of America
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Roheel A, Khan A, Anwar F, Akbar Z, Akhtar MF, Imran Khan M, Sohail MF, Ahmad R. Global epidemiology of breast cancer based on risk factors: a systematic review. Front Oncol 2023; 13:1240098. [PMID: 37886170 PMCID: PMC10598331 DOI: 10.3389/fonc.2023.1240098] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 09/11/2023] [Indexed: 10/28/2023] Open
Abstract
Background Numerous reviews of the epidemiology and risk factors for breast cancer have been published previously which heighted different directions of breast cancer. Aim The present review examined the likelihood that incidence, prevalence, and particular risk factors might vary by geographic region and possibly by food and cultural practices as well. Methods A systematic review (2017-2022) was conducted following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, reporting on epidemiological and risk factor reports from different world regions. Medical Subject Heading (MeSH) terms: "Breast neoplasm" "AND" country terms such as "Pakistan/epidemiology", "India/epidemiology", "North America/epidemiology", "South Africa/epidemiology" were used to retrieve 2068 articles from PubMed. After applying inclusion and exclusion terms, 49 papers were selected for systematic review. Results Results of selected articles were summarized based on risk factors, world regions and study type. Risk factors were classified into five categories: demographic, genetic and lifestyle risk factors varied among countries. This review article covers a variety of topics, including regions, main findings, and associated risk factors such as genetic factors, and lifestyle. Several studies revealed that lifestyle choices including diet and exercise could affect a person's chance of developing breast cancer. Breast cancer risk has also been linked to genetic variables, including DNA repair gene polymorphisms and mutations in the breast cancer gene (BRCA). It has been found that most of the genetic variability links to the population of Asia while the cause of breast cancer due to lifestyle modifications has been found in American and British people, indicating that demographic, genetic, and, lifestyle risk factors varied among countries. Conclusion There are many risk factors for breast cancer, which vary in their importance depending on the world region. However, further investigation is required to better comprehend the particular causes of breast cancer in these areas as well as to create efficient prevention and treatment plans that cater to the local population.
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Affiliation(s)
- Amna Roheel
- Riphah Institute of Pharmaceutical Sciences, Riphah International University, Lahore, Islamabad, Pakistan
| | - Aslam Khan
- Riphah Institute of Pharmaceutical Sciences, Riphah International University, Lahore, Islamabad, Pakistan
| | - Fareeha Anwar
- Riphah Institute of Pharmaceutical Sciences, Riphah International University, Lahore, Islamabad, Pakistan
| | - Zunaira Akbar
- Riphah Institute of Pharmaceutical Sciences, Riphah International University, Lahore, Islamabad, Pakistan
| | - Muhammad Furqan Akhtar
- Riphah Institute of Pharmaceutical Sciences, Riphah International University, Lahore, Islamabad, Pakistan
| | - Mohammad Imran Khan
- Riphah Institute of Pharmaceutical Sciences, Riphah International University, Lahore, Islamabad, Pakistan
| | - Mohammad Farhan Sohail
- Riphah Institute of Pharmaceutical Sciences, Riphah International University, Lahore, Islamabad, Pakistan
| | - Rizwan Ahmad
- Department of Natural Products, College of Clinical Pharmacy, Imam Andulrahman Bin Faisal University, Rakah, Dammam, Saudi Arabia
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Eden CM, Johnson J, Syrnioti G, Malik M, Ju T. The Landmark Series: The Breast Cancer Burden of the Asian American Population and the Need for Disaggregated Data. Ann Surg Oncol 2023; 30:2121-2127. [PMID: 36652024 PMCID: PMC9848042 DOI: 10.1245/s10434-023-13103-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 01/02/2023] [Indexed: 01/19/2023]
Abstract
The Asian American Pacific Islander (AAPI) population is a heterogeneous group of people from geographically and ethnically distinct regions of the world. Traditionally, these patients have been reported as one large aggregate in the breast cancer literature under the race category of "Asian." A detailed examination of this group shows compelling evidence that breast cancer manifests differently among Asian ethnic subgroups, resulting in overlooked health disparities when these races are grouped together. The AAPI community is the fastest growing ethnic group in the United States, and their incidence of breast cancer is increasing at rates greater than among their non-Asian counterparts. When these patients are disaggregated by race, they show wide variations in breast cancer screening, presentation, treatment, and outcomes. This population often faces additional unique challenges in the health care system due to cultural, social, health literacy, and language barriers, which can contribute to further disparity. Our landmark series aims to showcase the breadth of the breast cancer burden in the AAPI population and highlight the need for disaggregated ethnic data.
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Affiliation(s)
- Claire M Eden
- Department of Surgery New York Presbyterian Queens, Weill Cornell Medicine, Flushing, NY, USA
| | - Josh Johnson
- Department of Surgery New York Presbyterian, Weill Cornell Medicine, New York, NY, USA
| | - Georgia Syrnioti
- Department of Surgery New York Presbyterian, Weill Cornell Medicine, New York, NY, USA
| | - Manmeet Malik
- Department of Surgery New York Presbyterian Queens, Weill Cornell Medicine, Flushing, NY, USA
| | - Tammy Ju
- Department of Surgery New York Presbyterian Queens, Weill Cornell Medicine, Flushing, NY, USA.
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Islam D, Islam MS, Dorin SI, Jesmin. Prevalence of Breast Cancer Subtypes Among Different Ethnicities and Bangladeshi Women: Demographic, Clinicopathological, and Integrated Cancer Informatics Analysis. Cancer Inform 2023; 22:11769351221148584. [PMID: 36684416 PMCID: PMC9850134 DOI: 10.1177/11769351221148584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 12/13/2022] [Indexed: 01/19/2023] Open
Abstract
Background The molecular subtyping of breast cancer is related to estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2). The present study aimed to systematically analyze the expression, function, and prognostic value of ER, PR, HER2, and their prevalence in different ethnic groups and among Bangladeshi breast cancer (BC) patients. Method This study included 25 BC patients and 25 healthy controls, aged between 25 and 70 years. The study characteristics were compared using the ANOVA and Chi-square tests. Also, the multi-Omics dataset of 775 BC patients from TCGA was analyzed for ER, PR, and HER2 in breast cancer subtypes and compared among different ethnicities. Results For most BD breast cancer cases, the age at diagnosis was ⩾40 years, had only a histopathological diagnosis (P-value .004), and no history of mammography or other pathological tests. For treatment, had only chemotherapy (P-value .004) and no hormone therapy (P-value <.001). The majority of patients (>60%) were of stage-II cancer and TNBC (40%) subtype. The BC ethnicity-stratified data of ER, PR, and HER2 indicated a strong correlation across all ethnicities (P-value 4.99e-35; P-value 3.79e-18). The subtypes stratified data indicated a higher percentage of Luminal A (58.3%) in Caucasians whereas Luminal B (24.3%) and HER2 (25.2%) subtypes were found higher in Asians and TNBC (36.0%) were found in Africans. However, a significantly higher frequency of TNBC (52.2%) compared to Asians (14.8%) was found in BD patients (P-value <.001). The overall survival analysis of BC subtypes demonstrated that Luminal B (P-value .005) and HER2 enriched (P-value .015) were significantly more aggressive and were dominant in the Asian population. Conclusion A significant association was found between BC subtypes with different ethnicities and Bangladeshi women and these findings might aid in the prevention, management, and raising of awareness against risk factors in the near future.
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Affiliation(s)
- Diganta Islam
- Department of Genetic Engineering &
Biotechnology, University of Dhaka, Dhaka, Bangladesh
| | - Md. Shihabul Islam
- Department of Genetic Engineering &
Biotechnology, University of Rajshahi, Rajshahi, Bangladesh
| | - Sanjida Islam Dorin
- Department of Genetic Engineering &
Biotechnology, University of Dhaka, Dhaka, Bangladesh
| | - Jesmin
- Department of Genetic Engineering &
Biotechnology, University of Dhaka, Dhaka, Bangladesh,Jesmin, Department of Genetic Engineering
& Biotechnology, University of Dhaka, Dhaka-1000, Bangladesh.
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Lofterød T, Frydenberg H, Veierød MB, Jenum AK, Reitan JB, Wist EA, Thune I. The influence of metabolic factors and ethnicity on breast cancer risk, treatment and survival: The Oslo ethnic breast cancer study. Acta Oncol 2022; 61:649-657. [PMID: 35348396 DOI: 10.1080/0284186x.2022.2053573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND Breast cancer risk remains higher in high-income compared with low-income countries. However, it is unclear to what degree metabolic factors influence breast cancer development in women 30 years after immigration from low- to a high-incidence country. METHODS Using Cox regression models, we studied the association between pre-diagnostic metabolic factors and breast cancer development, and whether this association varied by ethnicity among 13,802 women participating in the population-based Oslo Ethnic Breast Cancer Study. Ethnic background was assessed and pre-diagnostic metabolic factors (body mass index, waist:hip ratio, serum lipids and blood pressure) were measured. A total of 557 women developed invasive breast cancer, and these women were followed for an additional 7.7 years. RESULTS Among women with an unfavorable metabolic profile, women from south Asia, compared with western European women, had a 2.3 times higher breast cancer risk (HR 2.30, 95% CI 1.18-4.49). Compared with the western European women, the ethnic minority women were more likely to present with triple-negative breast cancer (TNBC) (OR 2.11, 95% CI 0.97-4.61), and less likely to complete all courses of planned taxane treatment (OR 0.26, 95% CI 0.08-0.82). Among TNBC women, above-median triglycerides:HDL-cholesterol (>0.73) levels, compared with below-median triglycerides:HDL-cholesterol (≤0.73) levels, was associated with 2.9 times higher overall mortality (HR 2.88, 95% CI 1.02-8.11). CONCLUSIONS Our results support the importance of metabolic factors when balancing breast cancer prevention and disease management among all women, and in particular among non-western women migrating from a breast cancer low-incidence to a high-incidence country.
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Affiliation(s)
- Trygve Lofterød
- Department of Oncology, Oslo University Hospital, Ullevål, Norway
| | - Hanne Frydenberg
- Department of Oncology, Oslo University Hospital, Ullevål, Norway
| | - Marit B. Veierød
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Anne Karen Jenum
- General Practice Research Unit (AFE), Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Jon B. Reitan
- Department of Oncology, Oslo University Hospital, Ullevål, Norway
| | - Erik A. Wist
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Inger Thune
- Department of Oncology, Oslo University Hospital, Ullevål, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Health Services, UiT The Arctic University of Norway, Oslo, Norway
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Lo L, Satagopan JM. Factors Associated with Surgery Among South Asian American and Non-Hispanic White Women with Breast Cancer. AMERICAN JOURNAL OF UNDERGRADUATE RESEARCH 2021; 18:15-23. [PMID: 34970087 PMCID: PMC8716021 DOI: 10.33697/ajur.2021.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
South Asian American (SA) women are diagnosed with more aggressive breast cancer than non-Hispanic White (NHW) women. Understanding the factors associated with the types of surgery received by these women sheds light on disease management in these culturally distinct populations. We used data on age at diagnosis, stage, grade, estrogen and progesterone receptors, and surgery from 4,590 SA and 429,030 NHW breast cancer cases in the Surveillance, Epidemiology and End Results (SEER) program. We used logistic regression with surgery as the binary outcome (subcutaneous, total, or radical mastectomy (STRM) versus partial mastectomy, no, unknown or other (PNUM)) and included additive effects of all the variables and interactions of age, stage, grade, and estrogen and progesterone receptors with race/ethnicity. Type I error of 5% was used to assess statistical significance of the effects. SA were significantly more likely than NHW cases to receive STRM relative to PNUM surgery among women diagnosed at or after age 50 years and having localized stage disease (Odds Ratio (OR) = 1.27, 95% Confidence Interval (CI) = 1.06 - 1.52). Further, SA were significantly less likely than NHW cases to receive STRM relative to PNUM surgery among those diagnosed before age 50 years and having regional or distant stage disease (OR = 0.75, 95% CI = 0.59 - 0.95 for age at diagnosis < 40 years; OR = 0.77, 95% CI = 0.62 - 0.95 for age at diagnosis 40-49 years). The type of surgery received by SA and NHW women differ according to age at diagnosis and disease stage.
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Affiliation(s)
- Lydia Lo
- Department of Industrial and Systems Engineering, School of Engineering, Rutgers University, New Brunswick, NJ
| | - Jaya M. Satagopan
- Department of Biostatistics and Epidemiology & Center for South Asian Quantitative Health and Education, School of Public Health, Rutgers University, New Brunswick, NJ
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