Early-stage breast cancer treatment among medically underserved women diagnosed in a national screening program, 1992-1995

Citation
Lc. Richardson et al., Early-stage breast cancer treatment among medically underserved women diagnosed in a national screening program, 1992-1995, BREAST CANC, 69(2), 2001, pp. 133-142
Citations number
63
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Oncology,"Onconogenesis & Cancer Research
Journal title
BREAST CANCER RESEARCH AND TREATMENT
ISSN journal
0167-6806 → ACNP
Volume
69
Issue
2
Year of publication
2001
Pages
133 - 142
Database
ISI
SICI code
0167-6806(2001)69:2<133:EBCTAM>2.0.ZU;2-U
Abstract
Background. Little research has been conducted on the breast cancer treatme nt of low income, underserved women. This study was designed to describe in itial treatment of breast cancer among low-income women diagnosed through f ederally funded screening programs in Detroit, Michigan, and the states of New Mexico and California; and to compare the treatment received by program women with early-stage breast cancer with that of all women diagnosed in t hose regions. Methods. Data from the three screening programs were linked with cancer reg istry data from the corresponding geographic areas. All women diagnosed bet ween 1992 and 1995 through the state-based screening programs and all women contemporaneously diagnosed with breast cancer in the three regions were s tudied. Descriptive analyses were done of the proportion of women with brea st cancer receiving treatment; the proportion of early-stage breast cancer (stage I or II) cases treated with breast-conserving surgery, and the propo rtion treated with mastectomy; and among women with breast-conserving surge ry, the proportion receiving radiation therapy. Logistic regression models controlled for age and stage at diagnosis, race or ethnicity and geographic region. Results. Less than 2% of program women diagnosed with breast cancer receive d no treatment. More than two of five women with early-stage breast cancer underwent breast-conserving surgery, with 72% of these women receiving radi ation therapy. Multivariate regression analysis revealed that women with st age IIA or IIB breast cancer had lower odds of undergoing breast-conserving surgery than women with stage I (0.51 [95% CI = 0.30-0.87] and 0.36 [95% C I = 0.19-0.70], respectively). Women over age 65 and those with incompletel y staged cancer had the lowest odds for receiving radiation therapy after b reast-conserving surgery (0.29 [95% CI = 0.09-0.99] and 0.14 [95% CI = 0.03 -0.72], respectively). Women diagnosed through the screening programs had o dds of undergoing breast-conserving surgery similar to those of all women i n the regions (1.11 [95% CI = 0.89-1.39]). Conclusions. Treatment patterns for women diagnosed with early-stage breast cancer through three state-based screening programs appear to have been si milar to those reported in the literature. In addition, their treatment app ears to have been similar to that of other women during the same time perio d.