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Annals of Surgical Oncology
Erschienen in: Annals of Surgical Oncology 9/2015

01.09.2015 | Breast Oncology

Disparities in Breast Cancer Surgery Delay: The Lingering Effect of Race

verfasst von: Vanessa B. Sheppard, PhD, Bridget A. Oppong, MD, FACS, Regina Hampton, MD, FACS, Felicia Snead, MD, Sara Horton, MD, Fikru Hirpa, MA, Echo J. Brathwaite, MS, Kepher Makambi, PhD, S. Onyewu, MD, Marc Boisvert, MD, FACS, Shawna Willey, MD, FACS

Erschienen in: Annals of Surgical Oncology | Ausgabe 9/2015

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Abstract

Background

Delays to surgical breast cancer treatment of 90 days or more may be associated with greater stage migration. We investigated racial disparities in time to receiving first surgical treatment in breast cancer patients.

Methods

Insured black (56 %) and white (44 %) women with primary breast cancer completed telephone interviews regarding psychosocial (e.g., self-efficacy) and health care factors (e.g., communication). Clinical data were extracted from medical charts. Time to surgery was measured as the days between diagnosis and definitive surgical treatment. We also examined delays of more than 90 days. Unadjusted hazard ratios (HRs) examined univariate relationships between delay outcomes and covariates. Cox proportional hazard models were used for multivariate analyses.

Results

Mean time to surgery was higher in blacks (mean 47 days) than whites (mean 33 days; p = .001). Black women were less likely to receive therapy before 90 days compared to white women after adjustment for covariates (HR .58; 95 % confidence interval .44, .78). Health care process factors were nonsignificant in multivariate models. Women with shorter delay reported Internet use (vs. not) and underwent breast-conserving surgery (vs. mastectomy) (p < .01).

Conclusions

Prolonged delays to definitive breast cancer surgery persist among black women. Because the 90-day interval has been associated with poorer outcomes, interventions to address delay are needed.
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Metadaten
Titel
Disparities in Breast Cancer Surgery Delay: The Lingering Effect of Race
verfasst von
Vanessa B. Sheppard, PhD
Bridget A. Oppong, MD, FACS
Regina Hampton, MD, FACS
Felicia Snead, MD
Sara Horton, MD
Fikru Hirpa, MA
Echo J. Brathwaite, MS
Kepher Makambi, PhD
S. Onyewu, MD
Marc Boisvert, MD, FACS
Shawna Willey, MD, FACS
Publikationsdatum
01.09.2015
Verlag
Springer US
Erschienen in
Annals of Surgical Oncology / Ausgabe 9/2015
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-015-4397-3

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