Racial Differences in Patient-Reported Symptoms and Adherence to Adjuvant Endocrine Therapy Among Women With Early-Stage, Hormone Receptor–Positive Breast Cancer

Hu, Xin; Walker, Mark S.; Stepanski, Edward J.; Kaplan, Cameron M.; Martin, Michelle Y.; Vidal, Gregory A.; Schwartzberg, Lee S.; Graetz, Ilana

doi:10.1001/jamanetworkopen.2022.25485

Cited by 21 publications

(14 citation statements)

References 60 publications

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“…Interestingly, Black patients reported worse QOL with HT compared to White patients. Schleinitz et al and Hu et al, [ 16 , 35 ] reported the similar results as ours showing that Black women noted lower quality of life with HT during breast cancer treatments.…”

Section: Discussionsupporting

confidence: 88%

Factors associated with ductal carcinoma in situ (DCIS) treatment patterns and patient-reported outcomes across a large integrated health network

Kim

Wang

Demanelis

et al. 2022

Breast Cancer Res Treat

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Purpose To examine associations between ductal carcinoma in situ (DCIS) patients’ characteristics, treating locations and DCIS treatments received and to pilot assessing quality-of-life (QoL) values among DCIS patients with diverse backgrounds. Methods We performed a retrospective tumor registry review of all patients diagnosed and treated with DCIS from 2018 to 2019 in the UPMC-integrated network throughout central and western Pennsylvania. Demographics, clinical information, and administered treatments were compiled from tumor registry records. We categorized contextual factors such as different hospital setting (academic vs. community), socioeconomic status based on the neighborhood deprivation index (NDI) as well as age and race. QoL survey was administered to DCIS patients with diverse backgrounds via QoL questionnaire breast cancer module 23 and qualitative assessment questions. Results A total of 912 patients were reviewed. There were no treatment differences noted for age, race, or NDI. Mastectomy rate was higher in academic sites than community sites (29 vs. 20.4%; p = 0.0045), while hormone therapy (HT) utilization rate was higher in community sites (74 vs. 62%; p = 0.0012). QoL survey response rate was 32%. Only HT side effects negatively affected in QoL scores and there was no significant difference in QoL domains and decision-making process between races, age, NDI, treatment groups, and treatment locations. Conclusion Our integrated health network did not show chronically noted disparities arising from social determinates of health for DCIS treatments by implementing clinical pathways and system-wide peer review. Also, we demonstrated feasibility in collecting QoL for DCIS women with diverse backgrounds and different socioeconomic statuses.

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Section: Discussionsupporting

confidence: 88%

Factors associated with ductal carcinoma in situ (DCIS) treatment patterns and patient-reported outcomes across a large integrated health network

Kim

Wang

Demanelis

et al. 2022

Breast Cancer Res Treat

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“…There is limited data regarding the gynecologic outcomes of Black breast cancer survivors on tamoxifen. One particular retrospective cohort study investigated symptom burden by race and its relationship to endocrine therapy adherence [ 59 ]. Using data from a large multidisciplinary cancer center, researchers used 9 major symptom clusters, one of which was gynecologic symptoms.…”

Section: Tamoxifen Usementioning

confidence: 99%

Gynecologic Care of Black Breast Cancer Survivors

Pleasant

2024

Curr Breast Cancer Rep

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Purpose of Review Black patients suffer from breast cancer-related racial health disparities, which could have implications on their gynecologic care. This review explores considerations in the gynecologic care of Black breast cancer survivors. Recent Findings Black people have a higher risk of leiomyoma and endometrial cancer, which could confound bleeding patterns such as in the setting of tamoxifen use. As Black people are more likely to have early-onset breast cancer, this may have implications on long-term bone and heart health. Black patients may be more likely to have menopausal symptoms at baseline and as a result of breast cancer treatment. Furthermore, Black patients are less likely to utilize assisted reproductive technology and genetic testing services. Summary It is important for healthcare providers to be well-versed in the intersections of breast cancer and gynecologic care. Black breast cancer survivors may have unique considerations for which practitioners should be knowledgeable.

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“…Previous studies on other types of malignancies have demonstrated worse compliance with adjunctive therapy and poorer clinical outcomes among pediatric patients with SDOH disparities. 28,29 Univariate Analysis of Disparities in SDOH, Outcomes, and Follow-up…”

Section: Patient Demographicsmentioning

confidence: 99%

Social Determinants of Health and Associations With Outcomes in Pediatric Patients With Brain Tumors

et al. 2023

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BACKGROUND AND OBJECTIVES: Social determinants of health (SDOH) are nonmedical factors that affect health outcomes. Limited investigation has been completed on the potential association of these factors to adverse outcomes in pediatric populations. In this study, the authors aimed to analyze the effects of SDOH disparities and their relationship with outcomes after brain tumor resection or biopsy in children. METHODS: The authors retrospectively reviewed the records of their center's pediatric patients with brain tumor. Black race, public insurance, median household income, and distance to hospital were the investigated SDOH factors. Univariate analysis was completed between number of SDOH factors and patient demographics. Multivariate linear regression models were created to identify coassociated determinants and outcomes. RESULTS: A total of 272 patients were identified and included in the final analysis. Among these patients, 81 (29.8%) had no SDOH disparities, 103 (37.9%) had 1, 71 (26.1%) had 2, and 17 (6.2%) had 3. An increased number of SDOH disparities was associated with increased percentage of missed appointments (P = .002) and emergency room visits (P = .004). Univariate analysis demonstrated increased missed appointments (P = .01), number of postoperative imaging (P = .005), and number of emergency room visits (P = .003). In multivariate analysis, decreased median household income was independently associated with increased length of hospital stay (P = .02). CONCLUSION: The SDOH disparities are prevalent and impactful in this vulnerable population. This study demonstrates the need for a shift in research focus toward identifying the full extent of the impact of these factors on postoperative outcomes in pediatric patients with brain tumor.

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Racial Differences in Patient-Reported Symptoms and Adherence to Adjuvant Endocrine Therapy Among Women With Early-Stage, Hormone Receptor–Positive Breast Cancer

Abstract: This cohort study evaluates the differences in patient-reported symptoms and adherence to adjuvant endocrine therapy by race among women with early-stage breast cancer.

Cited by 21 publications

References 60 publications

Factors associated with ductal carcinoma in situ (DCIS) treatment patterns and patient-reported outcomes across a large integrated health network

Factors associated with ductal carcinoma in situ (DCIS) treatment patterns and patient-reported outcomes across a large integrated health network

Gynecologic Care of Black Breast Cancer Survivors

Social Determinants of Health and Associations With Outcomes in Pediatric Patients With Brain Tumors

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