scholarly journals Breast Cancer Prevalence and Management in Hispanic Women: Comparison to Black and White Women at a Regional Medical Center

2021 ◽  
pp. 127-136
Author(s):  
Sara Perregaux ◽  
Stella Self ◽  
Justin Collins ◽  
Sarah Renfro ◽  
Charlotte VanHale ◽  
...  
Keyword(s):  
Breast Cancer ◽  
White Women ◽  
Medical Center ◽  
Hispanic Women ◽  
Breast Cancers ◽  
Black And White ◽  
Regional Medical Center ◽  
Seer Data ◽  
Study Population ◽  
Mixed Histology

Background: While stage and grade of breast cancer determines prognosis and outcome, race also impacts survival. While Black and White women have been studied, data for Hispanic women is sparse. Methods: Age-matched Hispanic, Black and White women diagnosed/treated with breast cancer at a single institution were retrospectively evaluated regarding prevalence, treatments and outcomes. Results: Overall, 120 women were included in the study (40 per race). No demographic/histologic variables were significantly different among races. ER+/PR+ tumors were less frequent in Hispanics than Whites, but higher than Blacks. Prevalence of triple negative breast cancers in Hispanic women was between the Black and White cohorts (p=0.025 and p=0.011, respectively). Stage II and III diagnoses (p=0.025) were more frequent in Hispanics and they opted for chemotherapy more often (p=0.034); however, there were no significant differences in outcomes and mortality among groups. When compared to the State tumor registry, our population had more LCIS diagnoses (p=0.01), earlier stages (I p=0.02; II p=0.006), received more treatment overall (radiation p=0.02, chemotherapy p=0.0001) and experienced better survival (p=0.004). In comparing the study population to the SEER database, higher rates of LCIS and IDC and lower rates of ILC and mixed histology in the study population were noted. LCIS and IDC were more prevalent in our cohort than SEER data (p=0.005, p=0.05, respectively), although we noted less ILC and mixed histology (p=0.03 and p=0.04). Conclusion: These data are the first reported for Hispanics in our state and highlight the need for larger studies to better serve this growing demographic.

Geographical disparities of incidence and prevalence of triple-negative breast cancers: Multistate study data analysis.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e12599-e12599
Author(s):  
Hyein Jeon ◽  
Myeong Lee ◽  
Mohammed Jaloudi
Keyword(s):  
Breast Cancer ◽  
Black Women ◽  
Significant Relationship ◽  
White Women ◽  
Triple Negative ◽  
The State ◽  
Luminal A ◽  
Black Females ◽  
Black And White ◽  
State Effect

e12599 Background: Higher prevalence of triple negative breast cancer (TNBC) in black women with associated poor outcomes due to various disparities is well documented within a single state. We examine multiple states to better understand the state effect on such differences in incidence and prevalence of TNBC in black women. Methods: Female patients of ages 19 years old and above with breast cancer from the Surveillance, Epidemiology and End Results (SEER) Program across 13 states (608 counties) from 2015 (n = 66,444) and 2016 (n = 66,122) were examined. The relationships between the proportion of black and white women and the rate of patients with different tumor subtypes (luminal A, luminal B, HR-HER2+, and triple negative) were examined at the county level using ordinary least-square regression models. In parallel, due to consideration of various state-specific healthcare policies, socio-cultural norms, and socio-economic disparities, multi-level regression models were applied to examine the nested, random effect of each state on TNBC prevalence in each county. Bonferroni correction was applied to reduce the Type I error caused by repeated use of the same variables in multiple tests. Results: The baseline breast cancer rates between black and white women were similar in the population (0.171% for black and 0.168% for white). Consistent to previous studies, we demonstrate a significant positive correlation (p < 0.001) in TNBC in black females in both years. Surprisingly, when accounted for the random effects on states, 38.2% (2015) and 34.3% (2016) increase in incidence of TNBC in black females were seen, suggestive of state-specific disparity affecting race-specific health. In 2015, other subtypes of breast cancer in both black and white females did not result in significant relationship. Interestingly, in 2016, there was a significant relationship seen between the TNBC rate in white females and the white female population rate only after adjusting for the state effect (p = 0.026). This indicates the impact of non-biological factors such as state-wide health policies. Additionally, HR-HER2+ black females had a significant relationship against respective population rate only after adjusting for the state effect as well (p = 0.0394). For luminal A white females, a 15% decrease in incidence was seen after adjusting for state effect (p = 0.0424). Conclusions: This is the first known across-state examination of breast cancer subtypes by race with random effects on state. This study shows the role of state-specific factors affecting incidence in black and white females and potentially indicates the importance of state-level management for breast cancer on health disparities in addition to race-driven effects. Further studies are needed to elucidate comparable differences between states affecting the rates of various subtypes of breast cancer and thus health outcomes.

Breast Cancer: Factors Associated With Stage at Diagnosis in Black and White Women

1993 ◽  
Vol 85 (14) ◽  
pp. 1129-1137 ◽  
Author(s):  
C. P. Hunter ◽  
C. K. Redmond ◽  
V. W. Chen ◽  
D. F. Austin ◽  
R. S. Greenberg ◽  
...  
Keyword(s):  
Breast Cancer ◽  
White Women ◽  
Stage At Diagnosis ◽  
Factors Associated ◽  
Black And White

scholarly journals Breast cancer treatment delays by socioeconomic and health care access latent classes in Black and White women

Cancer ◽  
2020 ◽  
Vol 126 (22) ◽  
pp. 4957-4966
Author(s):  
Marc A. Emerson ◽  
Yvonne M. Golightly ◽  
Allison E. Aiello ◽  
Katherine E. Reeder‐Hayes ◽  
Xianming Tan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Cancer Treatment ◽  
Health Care Access ◽  
White Women ◽  
Breast Cancer Treatment ◽  
Latent Classes ◽  
Treatment Delays ◽  
Black And White ◽  
Care Access

scholarly journals Premenopausal gynecologic surgery and survival among black and white women with breast cancer

2019 ◽  
Vol 31 (2) ◽  
pp. 105-112
Author(s):  
Mya L. Roberson ◽  
Hazel B. Nichols ◽  
Andrew F. Olshan ◽  
Melissa A. Troester ◽  
Whitney R. Robinson
Keyword(s):  
Breast Cancer ◽  
White Women ◽  
Gynecologic Surgery ◽  
Black And White

scholarly journals Medicare D Subsidies and Racial Disparities in Persistence and Adherence With Hormonal Therapy

2016 ◽  
Vol 34 (36) ◽  
pp. 4398-4404 ◽  
Author(s):  
Alana Biggers ◽  
Yushu Shi ◽  
John Charlson ◽  
Elizabeth C. Smith ◽  
Alicia J. Smallwood ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Black Women ◽  
Hormonal Therapy ◽  
Low Income ◽  
White Women ◽  
Hispanic Women ◽  
Ethnic Disparities ◽  
Black Patients ◽  
Hispanic Patients ◽  
White Patients

Purpose To investigate the role of out-of-pocket cost supports through the Medicare Part D Low-Income Subsidy on disparities in breast cancer hormonal therapy persistence and adherence by race or ethnicity. Methods A nationwide cohort of women age ≥ 65 years with a breast cancer operation between 2006 and 2007 and at least one prescription filled for oral breast cancer hormonal therapy was identified from all Medicare D enrollees. The association of race or ethnicity with nonpersistence (90 consecutive days with no claims for a hormonal therapy prescription) and nonadherence (medication possession rate < 80%) was examined. Survival analyses were used to account for potential differences in age, comorbidity, or intensity of other treatments. Results Among the 25,111 women in the study sample, 77% of the Hispanic and 70% of the black women received a subsidy compared with 21% of the white women. By 2 years, 69% of black and 70% of Hispanic patients were persistent compared with 61% of white patients. In adjusted analyses, patients in all three unsubsidized race or ethnicity groups had greater discontinuation than subsidized groups (white patients: hazard ratio [HR], 1.83; 95% CI, 1.70 to 1.95; black patients: HR, 2.09; 95% CI, 1.73 to 2.51; Hispanic patients: HR, 3.00; 95% CI, 2.37 to 3.89). Racial or ethnic persistence disparities that were present for unsubsidized patients were not present or reversed among subsidized patients. All three subsidized race or ethnicity groups also had higher adherence than all three unsubsidized groups, although with the smallest difference occurring in black women. Conclusion Receipt of a prescription subsidy was associated with substantially improved persistence to breast cancer hormonal therapy among white, black, and Hispanic women and lack of racial or ethnic disparities in persistence. Given high subsidy enrollment among black and Hispanic women, policies targeted at low-income patients have the potential to also substantially reduce racial and ethnic disparities.

Disparities at the Intersection of Race and Ethnicity: Examining Trends and Outcomes in Hispanic Women With Breast Cancer

2020 ◽  
pp. OP.20.00381
Author(s):  
Cosette D. Champion ◽  
Samantha M. Thomas ◽  
Jennifer K. Plichta ◽  
Edgardo Parrilla Castellar ◽  
Laura H. Rosenberger ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Black Women ◽  
Racial Differences ◽  
White Women ◽  
Hispanic Women ◽  
Hazard Ratio ◽  
Tumor Subtype ◽  
Hispanic Patients ◽  
Race Ethnicity ◽  
Hispanic White

PURPOSE: We sought to examine tumor subtype, stage at diagnosis, time to surgery (TTS), and overall survival (OS) among Hispanic patients of different races and among Hispanic and non-Hispanic (NH) women of the same race. METHODS: Women 18 years of age or older who had been diagnosed with stage 0-IV breast cancer and who had undergone lumpectomy or mastectomy were identified in the National Cancer Database (2004-2014). Tumor subtype and stage at diagnosis were compared by race/ethnicity. Multivariable linear regression and Cox proportional hazards modeling were used to estimate associations between race/ethnicity and adjusted TTS and OS, respectively. RESULTS: A total of 44,374 Hispanic (American Indian [AI]: 79 [0.2%]; Black: 1,011 [2.3%]; White: 41,126 [92.7%]; Other: 2,158 [4.9%]) and 858,634 NH women (AI: 2,319 [0.3%]; Black: 97,206 [11.3%]; White: 727,270 [84.7%]; Other: 31,839 [3.7%]) were included. Hispanic Black women had lower rates of triple-negative disease (16.2%) than did NH Black women (23.5%) but higher rates than did Hispanic White women (13.9%; P < .001). Hispanic White women had higher rates of node-positive disease (23.2%) versus NH White women (14.4%) but slightly lower rates than Hispanic (24.6%) and NH Black women (24.5%; P < .001). Hispanic White women had longer TTS versus NH White women regardless of treatment sequence (adjusted means: adjuvant chemotherapy, 42.71 v 38.60 days; neoadjuvant chemotherapy, 208.55 v 201.14 days; both P < .001), but there were no significant racial differences in TTS among Hispanic patients. After adjustment, Hispanic White women (hazard ratio, 0.77 [95% CI, 0.74 to 0.81]) and Black women (hazard ratio, 0.75 [95% CI, 0.58 to 0.96]) had improved OS versus NH White women (reference) and Black women (hazard ratio, 1.15 [95% CI, 1.12 to 1.18]; all P < .05). CONCLUSION: Hispanic women had improved OS versus NH women, but racial differences in tumor subtype and nodal stage among Hispanic women highlight the importance of disaggregating racial/ethnic data in breast cancer research.

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