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King TA, Mittendorf EA. Breast Articles From 2023: Informing Practice Across the Continuum of Care. Ann Surg Oncol 2024; 31:4470-4476. [PMID: 38734863 DOI: 10.1245/s10434-024-15387-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 04/17/2024] [Indexed: 05/13/2024]
Abstract
With new investigations and clinical trials in breast oncology reported every year, it is critical that surgeons be aware of advances and insights into the evolving care paradigms and treatments available to their patients. This article highlights five publications found to be particularly impactful this past year. These articles report on efforts to select the minimal effective dose of tamoxifen for prevention, to challenge the existing age-based screening guidelines as they relate to race and ethnicity, to refine axillary management treatment standards, to optimize systemic therapy in multidisciplinary care settings, and to reduce the burden of breast cancer-related lymphedema after treatment. Taken together, these efforts have an impact on all facets of the continuum of care from prevention and screening through treatment and survivorship.
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Affiliation(s)
- Tari A King
- Division of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.
- Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
| | - Elizabeth A Mittendorf
- Division of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA
- Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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2
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Pederson HJ, Al-Hilli Z, Kurian AW. Racial disparities in breast cancer risk factors and risk management. Maturitas 2024; 184:107949. [PMID: 38652937 DOI: 10.1016/j.maturitas.2024.107949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 02/03/2024] [Accepted: 02/19/2024] [Indexed: 04/25/2024]
Abstract
Racial disparities in breast cancer outcomes are well described across the spectrum of screening, diagnosis, treatment, and survivorship. Breast cancer mortality is markedly elevated for Non-Hispanic Black women compared with other racial and ethnic groups, with multifactorial causes. Here, we aim to reduce this burden by identifying disparities in breast cancer risk factors, risk assessment, and risk management before breast cancer is diagnosed. We describe a reproductive profile and modifiable risk factors specific to the development of triple-negative breast cancer. We also propose that screening strategies should be both risk- and race-based, given the prevalence of early-onset triple-negative breast cancer in young Black women. We emphasize the importance of early risk assessment and identification of patients at hereditary and familial risk and discuss indications for a high-risk referral. We discuss the subtleties following genetic testing and highlight "uncertain" genetic testing results and risk estimation challenges in women who test negative. We trace aspects of the obesity epidemic in the Black community to infant feeding patterns and emphasize healthy eating and activity. Finally, we discuss building an environment of trust to foster adherence to recommendations, follow-up care, and participation in clinical trials. Addressing relevant social determinants of health; educating patients and clinicians on factors impacting disparities in outcomes; and encouraging participation in targeted, culturally sensitive research are essential to best serve all communities.
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Affiliation(s)
- Holly J Pederson
- Breast Center, Integrated Surgical Institute, Cleveland Clinic, 9500 Euclid Avenue, A80, OH 44195, United States of America.
| | - Zahraa Al-Hilli
- Breast Center, Integrated Surgical Institute, Cleveland Clinic, 9500 Euclid Avenue, A80, OH 44195, United States of America.
| | - Allison W Kurian
- Department of Medicine and Epidemiology and Population Health, Stanford University, 900 Blake Wilbur Drive, 1st Floor, Palo Alto, CA 94304, United States of America.
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3
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Kirkpatrick DR, Kobayashi H, Walker HM, Tuttle RM. Initiation of Breast Cancer Screening at a Later Age May Disproportionately Impact Minority Groups: Review of Ohio Data (1996-2022). Am Surg 2024; 90:897-901. [PMID: 37993112 DOI: 10.1177/00031348231216487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
Among women with breast cancer, delays in diagnosis and earlier presentation have been documented among minority women. Consequently, initiation of breast cancer screening at a later age may disproportionately harm minority groups. This study seeks to determine whether minority women face a higher proportional risk of younger age breast cancer than their White peers. Using publicly available data from the Ohio Department of Public Health Data Warehouse, we constructed a database allowing for retrospective evaluation of all breast cancer patients in the state of Ohio from 1996 to 2020. White women represented the bulk of total breast cancer cases in each age group and overall; however, the proportion of cancers attributable to White women increased in each successively older cohort group: 80.7% of cases under age 40 up to 91.3% of the 80 or older group. By a significant margin, the opposite is true in minority groups with African American women accounting for 15% of cases under the age of 40, trending down to 7.8% of the 80 and older group. Comparison of the proportions of these groups demonstrates statistically significant proportional decreases among minority groups and statistically significant increases among White women. Our findings suggest that women of color in the Ohio population face a disproportionately high risk of being diagnosed with younger age breast cancer and support the findings of other authors who recommend tailoring breast cancer screening by racial cohort. Efforts should be made to promote younger-age screening for minority women to prevent disproportionate harm.
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Affiliation(s)
| | | | - Hannah M Walker
- Department of Surgery, Wright State University Boonschoft School of Medicine, Dayton, OH, USA
| | - Rebecca M Tuttle
- Department of Surgery, Wright State University Boonschoft School of Medicine, Dayton, OH, USA
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4
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Chen JC, Stover DG, Ballinger TJ, Bazan JG, Schneider BP, Andersen BL, Carson WE, Obeng-Gyasi S. Racial Disparities in Breast Cancer: from Detection to Treatment. Curr Oncol Rep 2024; 26:10-20. [PMID: 38100011 DOI: 10.1007/s11912-023-01472-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2023] [Indexed: 02/12/2024]
Abstract
PURPOSE OF REVIEW Update on current racial disparities in the detection and treatment of breast cancer. RECENT FINDINGS Breast cancer remains the leading cause of cancer death among Black and Hispanic women. Mammography rates among Black and Hispanic women have surpassed those among White women, with studies now advocating for earlier initiation of breast cancer screening in Black women. Black, Hispanic, Asian, and American Indian and Alaskan Native women continue to experience delays in diagnosis and time to treatment. Further, racial discrepancies in receipt of guideline-concordant care, access to genetic testing and surgical reconstruction persist. Disparities in the initiation, completion, toxicity, and efficacy of chemotherapy, endocrine therapy, and targeted drug therapy remain for racially marginalized women. Efforts to evaluate the impact of race and ethnicity across the breast cancer spectrum are increasing, but knowledge gaps remain and further research is necessary to reduce the disparity gap.
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Affiliation(s)
- J C Chen
- Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center and James Cancer Hospital, Columbus, OH, USA
| | - Daniel G Stover
- Department of Internal Medicine, The Ohio State University Wexner Medical Center and James Cancer Hospital, Columbus, OH, USA
| | - Tarah J Ballinger
- Department of Internal Medicine, Indiana University, Indianapolis, IN, USA
| | - Jose G Bazan
- Department of Radiation Oncology, City of Hope, Duarte, CA, USA
| | - Bryan P Schneider
- Department of Internal Medicine, Indiana University, Indianapolis, IN, USA
| | | | - William E Carson
- Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center and James Cancer Hospital, Columbus, OH, USA
| | - Samilia Obeng-Gyasi
- Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center and James Cancer Hospital, Columbus, OH, USA.
- The Ohio State University, N924 Doan Hall, 410 West 10th, Columbus, OH, 43210, USA.
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Wilson B, Mendez J, Newman L, Lum S, Joseph KA. Addressing Data Aggregation and Data Inequity in Race and Ethnicity Reporting and the Impact on Breast Cancer Disparities. Ann Surg Oncol 2024; 31:42-48. [PMID: 37840113 DOI: 10.1245/s10434-023-14432-0] [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: 08/06/2023] [Accepted: 09/27/2023] [Indexed: 10/17/2023]
Abstract
Collecting and reporting data on race and ethnicity is vital to understanding and addressing health disparities in the United States. These health disparities can include increased prevalence and severity of disease, poorer health outcomes, decreased access to healthcare, etc., in disadvantaged populations compared with advantaged groups. Without these data, researchers, administrators, public health practitioners, and policymakers are unable to identify the need for targeted interventions and assistance. When researching or reporting on race and ethnicity, typically broad racial categories are used. These include White or Caucasian, Black or African American, Asian American, Native Hawaiian or Other Pacific Islander, or American Indian and Alaska Native, as well as categories for ethnicity such as Latino or Hispanic or not Latino or Hispanic. These categories, defined by the Office of Management and Budget, are the minimum standards for collecting and reporting race and ethnicity data across federal agencies. Of note, these categories have not been updated since 1997. The lack of accurate and comprehensive data on marginalized racial and ethnic groups limits our understanding of and ability to address health disparities. This has implications for breast cancer outcomes in various populations in this country. In this paper, we examine the impact data inequity and the lack of data equity centered processes have in providing appropriate prevention and intervention efforts and resource allocations.
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Affiliation(s)
| | | | - Lisa Newman
- Department of Surgery, Weill Cornell Medicine, New York, NY, USA
| | - Sharon Lum
- Department of Surgery, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Kathie-Ann Joseph
- Departments of Surgery and Population Health, New York University Grossman School of Medicine, New York, NY, USA.
- New York University Langone Health Institute of Excellence in Health Equity, New York, NY, USA.
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Zeballos Torrez CR, Gasior JA, Ginzberg SP, Nunes LW, Fayanju OM, Englander BS, Elmore LC, Edmonds CE. Identifying and Addressing Barriers to Screening Mammography in a Medically Underserved Community. Acad Radiol 2023:S1076-6332(23)00688-8. [PMID: 38151382 DOI: 10.1016/j.acra.2023.12.013] [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: 10/17/2023] [Revised: 12/05/2023] [Accepted: 12/05/2023] [Indexed: 12/29/2023]
Abstract
RATIONALE AND OBJECTIVES Breast cancer mortality is 40% higher for Black women compared to White women. This study seeks to assess knowledge of breast cancer screening recommendations and identify barriers to risk assessment and mammographic screening among a medically underserved, low-income, predominantly Black community in West Philadelphia. MATERIALS AND METHODS During a free mobile mammography screening event, women were offered surveys to assess perceptions of and barriers to breast cancer risk assessment and screening. Among those who subsequently underwent mobile screening, health insurance and time to additional diagnostic imaging and biopsy, when relevant, were retrospectively collected. RESULTS 233 women completed surveys (mean age 54 ± 13 years). Ninety-three percent of respondents identified as Black. The most frequently cited barrier to screening mammography was cost and/or lack of insurance coverage (30%). Women under 50 reported more barriers to screening compared to older women. Among those recalled from screening and recommended to undergo biopsy, there was a trend toward longer delays between screening and biopsy among those without a PCP (median 45 days, IQR 25-53) compared to those with a PCP (median 24 days, IQR 16-29) (p = 0.072). CONCLUSION In a study of a medically underserved community of primarily Black patients, barriers to breast cancer risk assessment, screening, and diagnosis were identified by self-report and by documented care delays. While free mobile mammography initiatives that bring medical professionals into communities can help mitigate barriers to screening, strategies for navigation and coordination of follow-up are critical to promote timely diagnostic resolution for all patients.
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Affiliation(s)
- Carla R Zeballos Torrez
- Department of Radiology, University of Pennsylvania Health System, 3400 Spruce Street, Philadelphia, PA (C.R.Z.T., L.W.N., B.S.E., C.E.E.).
| | - Julia Anna Gasior
- Department of Surgery, University of Pennsylvania Health System, 3400 Spruce Street, Philadelphia, PA (J.A.G., S.P.G., O.M.F., L.C.E.,)
| | - Sara P Ginzberg
- Department of Surgery, University of Pennsylvania Health System, 3400 Spruce Street, Philadelphia, PA (J.A.G., S.P.G., O.M.F., L.C.E.,); Penn Center for Cancer Care Innovation, University of Pennsylvania Health System, 3400 Civic Center Boulevard, Philadelphia PA (S.P.G.)
| | - Linda W Nunes
- Department of Radiology, University of Pennsylvania Health System, 3400 Spruce Street, Philadelphia, PA (C.R.Z.T., L.W.N., B.S.E., C.E.E.)
| | - Oluwadamilola M Fayanju
- Department of Surgery, University of Pennsylvania Health System, 3400 Spruce Street, Philadelphia, PA (J.A.G., S.P.G., O.M.F., L.C.E.,)
| | - Brian S Englander
- Department of Radiology, University of Pennsylvania Health System, 3400 Spruce Street, Philadelphia, PA (C.R.Z.T., L.W.N., B.S.E., C.E.E.)
| | - Leisha C Elmore
- Department of Surgery, University of Pennsylvania Health System, 3400 Spruce Street, Philadelphia, PA (J.A.G., S.P.G., O.M.F., L.C.E.,)
| | - Christine E Edmonds
- Department of Radiology, University of Pennsylvania Health System, 3400 Spruce Street, Philadelphia, PA (C.R.Z.T., L.W.N., B.S.E., C.E.E.)
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Ginzberg SP, Edmonds CE, Dako F, Donnell T, Washington AL, Elmore LC, Lee DJ, Vachani A, Mincarelli D, Zeballos Torrez C, McCormick TM, Rodriguez V, Nguyen V, Oliva C, Atherholt B, Gaiser R, Congiu L, Grant B, Gungor M, Englander BS, Guerra CE, Nunes LW. Together We Go Farther: Improving Access to Cancer Screening Through a Multidisciplinary, One-Stop-Shop Approach. Acad Radiol 2023; 30:3153-3161. [PMID: 37714719 DOI: 10.1016/j.acra.2023.07.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 07/15/2023] [Accepted: 07/20/2023] [Indexed: 09/17/2023]
Abstract
RATIONALE AND OBJECTIVES Despite significant scientific advances in cancer treatment in recent decades, Black Americans still face marked inequities in cancer screening, diagnosis, and treatment. Redressing these persistent inequities will require innovative strategies for community engagement. Radiologists, as experts in cancer screening and diagnosis for multiple malignancies, including breast, lung, and colon, are ideally suited to lead and implement community-based strategies to address local cancer disparities. MATERIALS AND METHODS Through an established academic-community partnership in West Philadelphia built over the course of multiple prior community healthcare events, the authors piloted a novel radiology-led multidisciplinary approach to improve access to cancer screening for the predominantly Black, medically-underserved residents. Using a "one-stop-shop" framework to provide a comprehensive suite of screening and ancillary services in the heart of the community, the authors sought to remove as many impediments to screening as possible. RESULTS Approximately 350 participants attended the health fair, and a total of 232 screening tests or assessments were completed. Data from this event suggest that this inclusive approach, as well as the use of a health fair "passport" to incentivize engagement, can successfully improve access to screening and follow-up in an underserved community. CONCLUSION This "one-stop-shop" community approach can be replicated by radiology-led teams in other settings as a high-value, scalable opportunity to reduce disparities in access to cancer screening.
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Affiliation(s)
- Sara P Ginzberg
- Department of Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania (S.P.G., L.C.E., D.J.L.); Abramson Cancer Center, University of Pennsylvania Health System, Philadelphia, Pennsylvania (S.P.G., C.E.E., A.L.W., L.C.E., D.J.L., A.V., V.R., V.N., C.E.G.)
| | - Christine E Edmonds
- Abramson Cancer Center, University of Pennsylvania Health System, Philadelphia, Pennsylvania (S.P.G., C.E.E., A.L.W., L.C.E., D.J.L., A.V., V.R., V.N., C.E.G.); Department of Radiology, University of Pennsylvania Health System, Philadelphia, Pennsylvania (C.E.E., F.D., C.Z.T., C.O., B.A., R.G., B.S.E., L.W.N.).
| | - Farouk Dako
- Department of Radiology, University of Pennsylvania Health System, Philadelphia, Pennsylvania (C.E.E., F.D., C.Z.T., C.O., B.A., R.G., B.S.E., L.W.N.)
| | | | - Armenta L Washington
- Abramson Cancer Center, University of Pennsylvania Health System, Philadelphia, Pennsylvania (S.P.G., C.E.E., A.L.W., L.C.E., D.J.L., A.V., V.R., V.N., C.E.G.)
| | - Leisha C Elmore
- Department of Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania (S.P.G., L.C.E., D.J.L.); Abramson Cancer Center, University of Pennsylvania Health System, Philadelphia, Pennsylvania (S.P.G., C.E.E., A.L.W., L.C.E., D.J.L., A.V., V.R., V.N., C.E.G.)
| | - Daniel J Lee
- Department of Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania (S.P.G., L.C.E., D.J.L.); Abramson Cancer Center, University of Pennsylvania Health System, Philadelphia, Pennsylvania (S.P.G., C.E.E., A.L.W., L.C.E., D.J.L., A.V., V.R., V.N., C.E.G.)
| | - Anil Vachani
- Abramson Cancer Center, University of Pennsylvania Health System, Philadelphia, Pennsylvania (S.P.G., C.E.E., A.L.W., L.C.E., D.J.L., A.V., V.R., V.N., C.E.G.); Department of Medicine, University of Pennsylvania Health System, Philadelphia, Pennsylvania (A.V., C.E.G.)
| | - Deborah Mincarelli
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Health System, Philadelphia, Pennsylvania (D.M.)
| | - Carla Zeballos Torrez
- Department of Radiology, University of Pennsylvania Health System, Philadelphia, Pennsylvania (C.E.E., F.D., C.Z.T., C.O., B.A., R.G., B.S.E., L.W.N.)
| | - Thomas M McCormick
- Patient Accounting, University of Pennsylvania Health System, Philadelphia, Pennsylvania (T.M.M.)
| | - Veronica Rodriguez
- Abramson Cancer Center, University of Pennsylvania Health System, Philadelphia, Pennsylvania (S.P.G., C.E.E., A.L.W., L.C.E., D.J.L., A.V., V.R., V.N., C.E.G.)
| | - Vivian Nguyen
- Abramson Cancer Center, University of Pennsylvania Health System, Philadelphia, Pennsylvania (S.P.G., C.E.E., A.L.W., L.C.E., D.J.L., A.V., V.R., V.N., C.E.G.)
| | - Catherine Oliva
- Department of Radiology, University of Pennsylvania Health System, Philadelphia, Pennsylvania (C.E.E., F.D., C.Z.T., C.O., B.A., R.G., B.S.E., L.W.N.)
| | - Barbara Atherholt
- Department of Radiology, University of Pennsylvania Health System, Philadelphia, Pennsylvania (C.E.E., F.D., C.Z.T., C.O., B.A., R.G., B.S.E., L.W.N.)
| | - Raymond Gaiser
- Department of Radiology, University of Pennsylvania Health System, Philadelphia, Pennsylvania (C.E.E., F.D., C.Z.T., C.O., B.A., R.G., B.S.E., L.W.N.)
| | - Lawrence Congiu
- Information Services, University of Pennsylvania Health System, Philadelphia, Pennsylvania (L.C.)
| | - Brandon Grant
- Office of the Chief Executive Officer, University of Pennsylvania Health System, Philadelphia, Pennsylvania (B.G.)
| | - Murat Gungor
- Senior Vice President of Diagnostic Imaging, Siemens Healthineers, Malvern, Pennsylvania (M.G.)
| | - Brian S Englander
- Department of Radiology, University of Pennsylvania Health System, Philadelphia, Pennsylvania (C.E.E., F.D., C.Z.T., C.O., B.A., R.G., B.S.E., L.W.N.)
| | - Carmen E Guerra
- Abramson Cancer Center, University of Pennsylvania Health System, Philadelphia, Pennsylvania (S.P.G., C.E.E., A.L.W., L.C.E., D.J.L., A.V., V.R., V.N., C.E.G.); Department of Medicine, University of Pennsylvania Health System, Philadelphia, Pennsylvania (A.V., C.E.G.)
| | - Linda W Nunes
- Department of Radiology, University of Pennsylvania Health System, Philadelphia, Pennsylvania (C.E.E., F.D., C.Z.T., C.O., B.A., R.G., B.S.E., L.W.N.)
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Keegan G, Crown A, DiMaggio C, Joseph KA. Insufficient Reporting of Race and Ethnicity in Breast Cancer Clinical Trials. Ann Surg Oncol 2023; 30:7008-7014. [PMID: 37658271 DOI: 10.1245/s10434-023-14201-z] [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: 05/16/2023] [Accepted: 08/09/2023] [Indexed: 09/03/2023]
Abstract
BACKGROUND Reporting race and ethnicity in clinical trial publications is critical for determining the generalizability and effectiveness of new treatments. This is particularly important for breast cancer, in which Black women have been shown to have between 40 and 100% higher mortality rate yet are underrepresented in trials. Our objective was to describe changes over time in the reporting of race/ethnicity in breast trial publications. PATIENTS AND METHODS We searched ClinicalTrials.gov to identify the primary publication linked to trials with results posted from May 2010-2022. Statistical analysis included summed frequencies and a linear regression model of the proportion of articles reporting race/ethnicity and the proportion of non-White enrollees over time. RESULTS A proportion of 72 of the 98 (73.4%) studies that met inclusion criteria reported race/ethnicity. In a linear regression model of the proportion of studies reporting race/ethnicity as a function of time, there was no statistically significant change, although we detected a signal toward a decreasing trend (coefficient for quarter = -2.2, p = 0.2). Among all studies reporting race and ethnicity over the study period, the overall percentage of non-White enrollees during the study period was 21.9%, [standard error (s.e.) 1.8, 95% confidence interval (CI) 18.4, 25.5] with a signal towards a decreasing trend in Non-White enrollment [coefficient for year-quarter = -0.8 (p = 0.2)]. CONCLUSION Our data demonstrate that both race reporting and overall representation of minority groups in breast cancer clinical trials did not improve over the last 12 years and may have, in fact, decreased. Increased reporting of race and ethnicity data forces the medical community to confront disparities in access to clinical trials. This may improve efforts to recruit and retain members of minority groups in clinical trials, and over time, reduce racial disparities in oncologic outcomes.
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Affiliation(s)
- Grace Keegan
- Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | - Angelena Crown
- True Family Women's Cancer Center, Swedish Cancer Institute, Seattle, WA, USA
| | - Charles DiMaggio
- Department of Surgery, NYU Grossman School of Medicine, New York, NY, USA
| | - Kathie-Ann Joseph
- Department of Surgery, NYU Grossman School of Medicine, NYULH Institute of Excellence in Health Equity, New York, NY, USA.
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9
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Crown A, Fazeli S, Kurian AW, Ochoa DA, Joseph KA. Disparity in Breast Cancer Care: Current State of Access to Screening, Genetic Testing, Oncofertility, and Reconstruction. J Am Coll Surg 2023; 236:1233-1239. [PMID: 36971366 DOI: 10.1097/xcs.0000000000000647] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
Breast cancer is the most common cancer diagnosed in women, accounting for an estimated 30% of all new cancer diagnoses in women in 2022. Advances in breast cancer treatment have reduced the mortality rate over the past 25 years by up to 34% but not all groups have benefitted equally from these improvements. These disparities span the continuum of care from screening to the receipt of guideline-concordant therapy and survivorship. At the 2022 American College of Surgeons Clinical Congress, a panel session was dedicated to educating and discussing methods of addressing these disparities in a coordinated manner. While there are multilevel solutions to address these disparities, this article focuses on screening, genetic testing, reconstruction, and oncofertility.
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Affiliation(s)
- Angelena Crown
- From the True Family Women's Cancer Center, Swedish Cancer Institute, Seattle, WA (Crown)
| | | | - Allison W Kurian
- Division of Oncology, Population Sciences Program, Stanford Cancer Institute, Stanford, CA (Kurian)
- Women's Clinical Cancer Genetics Program, Stanford University School of Medicine, Stanford, CA (Kurian)
| | - Daniela A Ochoa
- Division of Breast Surgical Oncology, Department of Surgery, University of Arkansas for Medical Science, Little Rock, AR (Ochoa)
| | - Kathie-Ann Joseph
- Department of Surgery, NYU Grossman School of Medicine, New York, NY (Joseph)
- NYU Langone Health Institute for Excellence in Health Equity, New York, NY (Joseph)
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10
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Crown A, Joseph KA. ASO Author Reflections: Optimizing Breast Cancer Risk Assessment and Screening Among Black Women. Ann Surg Oncol 2023; 30:1722-1723. [PMID: 36138285 DOI: 10.1245/s10434-022-12586-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 09/07/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Angelena Crown
- Breast Surgery, True Family Women's Cancer Center, Swedish Cancer Institute, Seattle, WA, USA
| | - Kathie-Ann Joseph
- Department of Surgery, New York University Grossman School of Medicine, New York, NY, USA. .,NYU Langone Health's Institute for Excellence in Health Equity, New York, NY, USA.
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