Racial disparities in surveillance mammography among older breast cancer survivors

Teysir, Jimmitti; Gegechkori, Nana; Wisnivesky, Juan P.

doi:10.1007/s10549-019-05250-8

Cited by 12 publications

(9 citation statements)

References 46 publications

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“…For example, all breast cancer survivors, regardless of genetic test results, undergo annual mammography Although limited by the absence of genetic test results, many large studies have used claims or registry data to understand adherence to breast surveillance among cancer survivors. 3,[15][16][17] These population level studies report a 70%-80% rate of mammographic surveillance in the first year after surgery or diagnosis among breast cancer survivors, which is comparable to the mammography rates of 70.8% among P/LP carriers and 72.1% among VUS carriers, in the first year after genetic testing, with personal history of breast cancer reported here. In contrast, breast MRI rates were much higher in this cohort of survivors who underwent genetic testing (34.9% for P/LP and 14.3% for VUS in year 1) compared to 9% in the population level.…”

Section: Discussionsupporting

confidence: 78%

“…Although limited by the absence of genetic test results, many large studies have used claims or registry data to understand adherence to breast surveillance among cancer survivors 3,15–17 . These population level studies report a 70%–80% rate of mammographic surveillance in the first year after surgery or diagnosis among breast cancer survivors, which is comparable to the mammography rates of 70.8% among P/LP carriers and 72.1% among VUS carriers, in the first year after genetic testing, with personal history of breast cancer reported here.…”

Section: Discussionsupporting

confidence: 56%

“…Previous studies of breast surveillance use have examined screening outcomes only among BRCA1/2-positive women, 9,14 many had small sample sizes, 14 or did not include genetic testing information. [15][16][17] Our study adds to the body of sparse literature on surveillance outcomes following a VUS genetic test result. 8,9,18 Of three studies that reported breast MRI rates among women with a VUS, two found similar rates of MRI use between VUS and P/LP variants with wide variation between studies (3% to ~30%).…”

Section: Discussionmentioning

confidence: 90%

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Use of breast surveillance between women with pathogenic variants and variants of uncertain significance in breast cancer susceptibility genes

Makhnoon

Chen

Levin

et al. 2022

Cancer

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Background Use of surveillance mammography and magnetic resonance imaging (MRI) has been understudied among women with variant of uncertain significance (VUS) compared to pathogenic and likely pathogenic variants (P/LP). Methods Using data from two cancer settings, we calculated use of risk‐reducing mastectomy (RRM) and surveillance during each 13‐month span after genetic testing up to 6 years afterwards for a cohort of genetically elevated risk women. Results Of 889 women, VUS carriers were less likely to undergo RRM compared to those with P/LP (hazard ratio [HR], 0.17; p = <.001) and high‐risk women were more likely to undergo RRM than average‐risk women (HR, 3.91; p = .005). Longitudinally, surveillance use among unaffected women decreased from 49.8% in the first year to 31.2% in the sixth year after genetic testing. In comparison, a greater proportion of women with a personal history of breast cancer underwent surveillance, which increased from 59.3% in the first year to 63.6% in the sixth year after genetic testing. Mammography rates did not differ between women with P/LP and VUS within the first 13 months after genetic testing and up to 4 years afterward. Over the first 4 years after genetic testing, women with VUS were less likely to undergo annual MRIs compared to P/LP. Conclusion The authors found that VUS, whether in high or moderate penetrance breast cancer susceptibility genes, was associated with lower use of annual breast MRI compared to P/LP variants and equivalent use of annual mammography. These results add important evidence regarding VUS‐related breast surveillance.

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Section: Discussionsupporting

confidence: 78%

Section: Discussionsupporting

confidence: 56%

Section: Discussionmentioning

confidence: 90%

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Use of breast surveillance between women with pathogenic variants and variants of uncertain significance in breast cancer susceptibility genes

Makhnoon

Chen

Levin

et al. 2022

Cancer

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“…Another possible explanation is that spouses may promote timely health screenings [21]. Studies have shown that married women are more likely to receive surveillance mammography [22,23] and participant in cervical cancer screening [24][25][26]. In addition, marriage may reduce risk-taking behavior and exert social control on behavior, such as diet and exercise [27,28].…”

Section: Discussionmentioning

confidence: 99%

The Impact of Marital Status on Stage at Diagnosis and Survival of Female Patients with Breast and Gynecologic Cancers: A Meta-Analysis

Yuan

Zhang

et al. 2020

Preprint

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Background: The aim of this meta-analysis is to evaluate the effect of marital status on the stage at diagnosis and survival of female patients with breast and gynecologic cancers.Methods: A systematic literature search was conducted on electronic databases (PubMed, Cochrane and EMBASE) till March 31, 2020. Publications investigating the association of marital status with stage at diagnosis and/or cancer-specific mortality (CSM) and/or overall survival (OS) in female patients with breast or gynecologic cancers were retrieved. After studies were selected according to inclusion criteria, data extraction, quality assessment and data analysis were performed. Results: 55 articles were eligible for inclusion, consisting of 1195773 female cancer patients with breast, vulvar, cervical, endometrial and ovarian cancers. Unmarried female cancer patients had higher odds of being diagnosed at later stage [odds ratio (OR) = 1.28, 95% confidence interval (CI): 1.22-1.36)] and worse survival outcomes in CSM [hazard ratio (HR) = 1.22, 95% CI: 1.16-1.28] and OS (HR = 1.20, 95% CI: 1.14-1.25). This estimate did not vary by level of social support, number of adjustment factors, or between America and Europe. Conclusions: Being married is associated with timely diagnosis and favorable prognosis in most women’s cancers. Unmarried female cancer patients have a higher risk of late-stage diagnosis and worse survival outcomes than the married. Greater concern shall be demonstrated towards unmarried female cancer patients. Furthermore, the impact of lacking economic and emotional support on survival outcomes in unmarried female cancer patients deserves particular attention.

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“…Understanding health disparities at the intersection of age and race is an active area of geriatric oncology HSR [55][56][57][58]. In a study of older men with prostate cancer using the SEER-Medicare dataset, racial disparities in treatment were assessed across strata of clinical benefit, which incorporated tumor risk and life expectancy [59].…”

Section: Patterns Of Care and Patient Outcomesmentioning

confidence: 99%

Geriatric oncology health services research: Cancer and Aging Research Group infrastructure core

Wong

Lichtman

Morrow

et al. 2020

Journal of Geriatric Oncology

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Racial disparities in surveillance mammography among older breast cancer survivors

Cited by 12 publications

References 46 publications

Use of breast surveillance between women with pathogenic variants and variants of uncertain significance in breast cancer susceptibility genes

Use of breast surveillance between women with pathogenic variants and variants of uncertain significance in breast cancer susceptibility genes

The Impact of Marital Status on Stage at Diagnosis and Survival of Female Patients with Breast and Gynecologic Cancers: A Meta-Analysis

Geriatric oncology health services research: Cancer and Aging Research Group infrastructure core

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