Primary tumor size, not race, determines outcomes in women with hormone-responsive breast cancer

Chagpar, Anees B.; Crutcher, Clifford R.; Cornwell, Laura B.; McMasters, Kelly M.

doi:10.1016/j.surg.2011.07.066

Cited by 14 publications

(14 citation statements)

References 17 publications

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“…1 However, not all women benefit equally from these advancements; low-income or black women continue to have higher breast cancer mortality rates compared with their higher income or white counterparts. 2 The causes of these disparities have been attributed to a myriad of factors, including decreased screening rates, 3 presentation at a more advanced stage, 2 increased prevalence of unfavorable basaltype cancer, 4 and delays in treatment initiation or incomplete treatment. 5,6 Effective solutions for vulnerable patients are crucial 7 as our national focus turns to improvement in access to and delivery of quality care.…”

Section: Introductionmentioning

confidence: 99%

Can Patient Navigation Improve Receipt of Recommended Breast Cancer Care? Evidence From the National Patient Navigation Research Program

Darnell²,

Calhoun³

et al. 2014

JCO

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Purpose Poor and underserved women face barriers in receiving timely and appropriate breast cancer care. Patient navigators help individuals overcome these barriers, but little is known about whether patient navigation improves quality of care. The purpose of this study is to examine whether navigated women with breast cancer are more likely to receive recommended standard breast cancer care. Patients and Methods Women with breast cancer who participated in the national Patient Navigation Research Program were examined to determine whether the care they received included the following: initiation of antiestrogen therapy in patients with hormone receptor–positive breast cancer; initiation of postlumpectomy radiation therapy; and initiation of chemotherapy in women younger than age 70 years with triple-negative tumors more than 1 cm. This is a secondary analysis of a multicenter quasi-experimental study funded by the National Cancer Institute to evaluate patient navigation. Multiple logistic regression was performed to compare differences in receipt of care between navigated and non-navigated participants. Results Among participants eligible for antiestrogen therapy, navigated participants (n = 380) had a statistically significant higher likelihood of receiving antiestrogen therapy compared with non-navigated controls (n = 381; odds ratio [OR], 1.73; P = .004) in a multivariable analysis. Among the participants eligible for radiation therapy after lumpectomy, navigated participants (n = 255) were no more likely to receive radiation (OR, 1.42; P = .22) than control participants (n = 297). Conclusion We demonstrate that navigated participants were more likely than non-navigated participants to receive antiestrogen therapy. Future studies are required to determine the full impact patient navigation may have on ensuring that vulnerable populations receive quality care.

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Section: Introductionmentioning

confidence: 99%

Can Patient Navigation Improve Receipt of Recommended Breast Cancer Care? Evidence From the National Patient Navigation Research Program

Darnell²,

Calhoun³

et al. 2014

JCO

View full text Add to dashboard Cite

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“…Small tumors are more likely to be treated successfully [5,6]. Delayed presentation of breast cancer is associated with advanced stage and low survival [7-9].…”

Section: Introductionmentioning

confidence: 99%

Diagnosis delay in Libyan female breast cancer

et al. 2012

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AimsTo study the diagnosis delay and its impact on stage of disease among women with breast cancer on Libya.Methods200 women, aged 22 to 75 years with breast cancer diagnosed during 2008–2009 were interviewed about the period from the first symptoms to the final histological diagnosis of breast cancer. This period (diagnosis time) was categorized into 3 periods: <3 months, 3–6 months, and >6 months. If diagnosis time was longer than 3 months, the diagnosis was considered delayed (diagnosis delay). Consultation time was the time taken to visit the general practitioner after the first symptoms. Retrospective preclinical and clinical data were collected on a form (questionnaire) during an interview with each patient and from medical records.ResultsThe median of diagnosis time was 7.5 months. Only 30.0% of patients were diagnosed within 3 months after symptoms. 14% of patients were diagnosed within 3–6 months and 56% within a period longer than 6 months. A number of factors predicted diagnosis delay: Symptoms were not considered serious in 27% of patients. Alternative therapy (therapy not associated with cancer) was applied in 13.0% of the patients. Fear and shame prevented the visit to the doctor in 10% and 4.5% of patients, respectively. Inappropriate reassurance that the lump was benign was an important reason for prolongation of the diagnosis time. Diagnosis delay was associated with initial breast symptom(s) that did not include a lump (p < 0.0001), with women who did not report monthly self examination (p < 0.0001), with old age (p = 0.004), with illiteracy (p = 0.009), with history of benign fibrocystic disease (p = 0.029) and with women who had used oral contraceptive pills longer than 5 years (p = 0.043). At the time of diagnosis, the clinical stage distribution was as follows: 9.0% stage I, 25.5% stage II, 54.0% stage III and 11.5% stage IV.Diagnosis delay was associated with bigger tumour size (p <0.0001), with positive lymph nodes (N2, N3; p < 0.0001), with high incidence of late clinical stages (p < 0.0001), and with metastatic disease (p < 0.0001).ConclusionsDiagnosis delay is very serious problem in Libya. Diagnosis delay was associated with complex interactions between several factors and with advanced stages. There is a need for improving breast cancer awareness and training of general practitioners to reduce breast cancer mortality by promoting early detection. The treatment guidelines should pay more attention to the early phases of breast cancer. Especially, guidelines for good practices in managing detectable of tumors are necessary.

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“…6 7 et al observed that the triple negative category of breast cancers in the Chinese population exhibits a different pattern of relapse, which indicates that different organotropism may be due to the different intrinsic subtypes based on the site-specific spread pattern in different subgroups and therefore they claimed that a better knowledge of the triple negative category is warranted for efficacious systemic regimens to decrease and/or delay the relapse hazard. 7 …”

Section: Devkota and Armbrecht Health Renaissance 2013; Vol 11 (No2);1mentioning

confidence: 99%

Two years' observational study of racial difference of breast cancer in patients presenting to a tertiary care hospital serving indigent population

Devkota

Armbrecht

2013

Health Renaissance

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Background: Breast cancer is the most common malignancy after non-melanoma skin cancers and second highest cause of cancer deaths (after lung cancer) in females. Objective: To assess racial difference of breast cancer in patients presenting to a tertiary care hospital serving indigent population. Methods: Medical records of 119 Caucasians and 146 African American women with pathologically proven breast cancer who were admitted in a tertiary care hospital serving the indigent population from January 2004 to December 2006 were reviewed retrospectively. Analysis of Variance was performed for within and between group differences using SPSS 19. Results: Our study showed that mean age of cancer diagnosis was much earlier (47.6 years) in white women whose second degree relatives have breast cancer than those women whose first degree relatives have breast cancer (58.6 years). However, in the black women this differencewas not observed (p value for white is 0.002 but for black it was 0 .94). Conclusion: Family history of women with breast cancer in this study showed history of breast cancer in a second degree female relative increased the risk of breast cancer in white women; positive history was associated with earlier age of onset of the disease. We suggest future studies should look into genetic and biological markers in the second generation family members for increased risk of breast cancer.

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Primary tumor size, not race, determines outcomes in women with hormone-responsive breast cancer

Cited by 14 publications

References 17 publications

Can Patient Navigation Improve Receipt of Recommended Breast Cancer Care? Evidence From the National Patient Navigation Research Program

Can Patient Navigation Improve Receipt of Recommended Breast Cancer Care? Evidence From the National Patient Navigation Research Program

Diagnosis delay in Libyan female breast cancer

Two years' observational study of racial difference of breast cancer in patients presenting to a tertiary care hospital serving indigent population

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