Relation between socioeconomic variables and surgical, systemic and radiation treatment in a cohort of patients with breast cancer in an urban Canadian centre

Li, Jennifer; Cornacchi, Sylvie D.; Farrokhyar, Forough; Johnston, Neil; Forbes, Shawn S.; Reid, Susan; Hodgson, Nicole; Lovrics, Sarah; Lucibello, Kristen; Lovrics, Peter

doi:10.1503/cjs.009217

Cited by 7 publications

(6 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We screened the titles and abstracts of 806 unique articles, assessed the full text of 70 articles, and found twelve articles that met all inclusion criteria for qualitative synthesis. [18][19][20][21][22][23][24][25][26][27][28][29] The selected articles ranged in publication date from 1997 to 2020 with data collected from 1970 to 2017. Three articles reported on data collected in the United States, three in China, and one each in Canada, United Kingdom, Denmark, Italy, Sweden, and Pakistan.…”

Section: Resultsmentioning

confidence: 99%

“…24 Two out of seven articles showed no relationship between education level and rates of BCS. 22,25 In articles that collected patients' incomes, most often self-reported, five out of seven showed that rates of BCS were lower (compared to mastectomy) among patients with lower income. 20,24,26,27,29 Two articles showed no relationship between income level and rates of BCS.…”

mentioning

confidence: 99%

See 1 more Smart Citation

How Does Patient Socioeconomic Position Affect Breast Cancer Surgical Treatment and Mortality?: A Rapid Review

Schubbe¹,

Yen²,

Durand³

2021

BCTT

View full text Add to dashboard Cite

Background: Breast cancer is the second leading cause of death in women across the world. Despite significant improvements in overall breast cancer survival, disparities still exist. Research shows that socioeconomic position (SEP) plays a strong role in disparities in breast cancer care. Lower SEP can be a predictor of poorer breast cancer health outcomes and treatment received. No recent review has focused on SEP and breast cancer surgery outcomes. We conducted a rapid review assessing how patient SEP affects breast cancer surgical outcomes. Methods: We developed and ran the search strategy in Ovid MEDLINE in January 2021. We assessed study eligibility using an adapted version of PICOS criteria. We included observational studies that assessed the relationship between SEP and breast cancer surgery treatment, including outcomes like surgery choice, survival, and wait time to surgery. We independently reviewed each article and independently extracted data using a pre-designed form. One reviewer narratively synthesized the data extracted from the included articles. Results: We found twelve articles that met inclusion criteria. Eight out of 12 articles showed a difference in breast cancer surgery outcomes based on at least one measure of SEP. Six out of eight articles that collected surgery choice data found that women with lower SEP had lower rates of breast conserving surgery. One out of three articles that collected survival data found that higher SEP had a positive effect on survival. Additionally, one article that collected wait time to surgery data found a significant correlation between lower SEP and longer delays to surgical treatment. Conclusion:In conclusion, our rapid review of SEP and breast cancer surgery outcomes found that there is a relationship between SEP and breast cancer surgery choice. This rapid review did not find enough evidence to see a relationship with overall survival and wait time to surgery.

show abstract

Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

How Does Patient Socioeconomic Position Affect Breast Cancer Surgical Treatment and Mortality?: A Rapid Review

Schubbe¹,

Yen²,

Durand³

2021

BCTT

View full text Add to dashboard Cite

show abstract

“…Some significant factors that affected this conclusion were employment, education, and the number of radiation oncologists in the areas examined. All significant variables were directly correlated with lower levels in rural areas creating a disparity [ 15 ]. Viewing things from a larger perspective, when examining breast cancer worldwide, a significant distinction was shown between urban and rural populations.…”

Section: Reviewmentioning

confidence: 99%

Real World and Public Health Perspectives of Intraoperative Radiotherapy in Early-Stage Breast Cancer: A Multidisciplinary Analysis Beyond the Statistical Facts

Vijayakumar¹,

Nittala²,

Buddala³

et al. 2023

Cureus

View full text Add to dashboard Cite

Breast conservation therapy (BCT) (usually a lumpectomy plus radiotherapy (RT)) has become a standard alternative to radical mastectomy in early-stage breast cancers with equal, if not higher, survival rates. The established standard of the RT component of the BCT had been about six weeks of Monday through Friday external beam RT to the whole breast (WBRT). Recent clinical trials have shown that partial breast radiation therapy (PBRT) to the region surrounding the lumpectomy cavity with shorter courses can result in equal local control, survival, and slightly improved cosmetic outcomes. Intraoperative RT (IORT) wherein RT is administered at the time of operation for BCT to the lumpectomy cavity as a single-fraction RT is also considered PBRT. The advantage of IORT is that weeks of RT are avoided. However, the role of IORT as part of BCT has been controversial. The extreme views go from “I will not recommend to anyone” to “I can recommend to all early-stage favorable patients.” These divergent views are due to difficulty in interpreting the clinical trial results. There are two modalities of delivering IORT, namely, the use of low-energy 50 kV beams or electron beams. There are several retrospective, prospective, and two randomized clinical trials comparing IORT versus WBRT. Yet, the opinions are divided. In this paper, we try to bring clarity and consensus from a highly broad-based multidisciplinary team approach. The multidisciplinary team included breast surgeons, radiation oncologists, medical physicists, biostatisticians, public health experts, nurse practitioners, and medical oncologists. We show that there is a need to more carefully interpret and differentiate the data based on electron versus low-dose X-ray modalities; the randomized study results have to be extremely carefully dissected from biostatistical points of view; the importance of the involvement of patients and families in the decision making in a very transparent and informed manner needs to be emphasized; and the compromise some women may be willing to accept between 2-4% potential increase in local recurrence (as interpreted by some of the investigators in IORT randomized studies) versus mastectomy. We conclude that, ultimately, the choice should be that of women with detailed facts of the pros and cons of all options being presented to them from the angle of patient/family-focused care. Although the guidelines of various professional societies can be helpful, they are only guidelines. The participation of women in IORT clinical trials is still needed, and as genome-based and omics -based fine-tuning of prognostic fingerprints evolve, the current guidelines need to be revisited. Finally, the use of IORT can help rural, socioeconomically, and infrastructure-deprived populations and geographic regions as the convenience of single-fraction RT and the possibility of breast preservation are likely to encourage more women to choose BCT than mastectomy. This option can also likely lead to more wom...

show abstract

“…An AI algorithm may flag a possibly questionable medical decision, acting as a needed check point. For example, a Canada-based study showed that when caring for breast cancer patients, employment status consistently predicted the use of systemic and radiation treatment [39]. Another study from Sweden showed that socioeconomic status differs between breast cancer patients treated with mastectomy and breast conservation, even in a national healthcare system that is expected to offer all women the same standard of care [40].…”

Section: Using Ai As a Tool To Combat Unconscious Bias In Medicinementioning

confidence: 99%

The Role of Artificial Intelligence in Understanding and Addressing Disparities in Breast Cancer Outcomes

Mema

McGinty

2020

Curr Breast Cancer Rep

View full text Add to dashboard Cite

Purpose of Review The goal of our paper is to explore the role of AI in understanding health disparities in cancer care and its potential role in resolving them. Recent Findings Multiple studies have shown that with the recent advances in AI, its integration in cancer care has the potential to impact earlier diagnosis and improve clinical decision making. While AI risks to further widen health disparities, some studies suggest that it represents an excellent opportunity for resolving them. Summary With active engagement, incorporating AI in breast cancer care represents an excellent opportunity for elucidating and resolving health disparities; however, without deliberate effort, it risks to further widen them.

show abstract

Relation between socioeconomic variables and surgical, systemic and radiation treatment in a cohort of patients with breast cancer in an urban Canadian centre

Cited by 7 publications

References 33 publications

How Does Patient Socioeconomic Position Affect Breast Cancer Surgical Treatment and Mortality?: A Rapid Review

How Does Patient Socioeconomic Position Affect Breast Cancer Surgical Treatment and Mortality?: A Rapid Review

Real World and Public Health Perspectives of Intraoperative Radiotherapy in Early-Stage Breast Cancer: A Multidisciplinary Analysis Beyond the Statistical Facts

The Role of Artificial Intelligence in Understanding and Addressing Disparities in Breast Cancer Outcomes

Contact Info

Product

Resources

About