Racial Differences in Definitive Breast Cancer Therapy in Older Women
Are They Explained by the Hospitals where Patients Undergo Surgery
Bibliographic Data
| ID | 9102815 |
|---|---|
| Authors | Nancy L Keating (0000-0002-8274-4681, Brigham and Women's Hospital, corresponding author), Elena Kouri, Elena M Kouri (Harvard University), Yulei He (0000-0002-8451-5452, Harvard University), Jane C Weeks, Eric P Winer (0000-0002-8819-1723) |
| Year | 2009 |
| Volume | 47 |
| Issue | 7 |
| Pages | 765-773 |
| Publication date | 2009-07-01 |
| Peer Reviewed | Yes |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/mlr.0b013e31819e1fe7 |
| PMID | 19536008 |
| OpenAlex | W1964205648 |
| Language | EN |
| Citations received | 10 |
| References cited | 38 |
BACKGROUND: Prior research has documented racial disparities in patterns of care and outcomes for women with breast cancer. OBJECTIVES: To assess whether black women receive care from lower-quality or lower-volume hospitals and if such differences explain disparities in receipt of definitive primary breast cancer therapy. RESEARCH DESIGN: Observational study of a population-based sample of breast cancer patients included in the SEER-Medicare database. SUBJECTS: Fifty five thousand four hundred seventy white or black women aged >65 diagnosed with stage I/II breast cancer during 1992-2002. MEASURES: Surgery at a high-quality hospital (top quartile rates of radiation after breast-conserving surgery) or high volume (top quartile) hospital and receipt of definitive primary therapy (mastectomy or breast-conserving surgery with radiation). RESULTS: Black women were significantly less likely than white women to be treated at high-quality hospitals (adjusted odds ratio [OR] 0.60; 95% confidence interval [CI]: 0.40-0.87) but not high-volume hospitals (adjusted OR 0.85; 95% CI: 0.54-1.34). Black women were less likely than white women to receive definitive primary therapy, a finding partially explained by having surgery at a high-quality hospital but not by having surgery at a high-volume hospital. CONCLUSIONS: Older black women were more likely than white women to undergo breast cancer surgery at hospitals with lower rates of radiation following breast-conserving surgery, and this explains some of the reported racial disparities previously observed in receipt of definitive therapy for early-stage breast cancer. Interventions to help hospitals treating large numbers of black women improve rates of radiation after breast-conserving surgery may help to decrease racial disparities in care
Breast cancer · Breast-conserving surgery · Cancer · Confidence interval · Mastectomy · Observational study · Odds ratio · Population · Quartile · Radiation therapy · Breast Cancer Treatment Studies · Breast Implant and Reconstruction · Global Cancer Incidence and Screening · Internal Medicine · Medicine
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| Unique citing works | 10 |
|---|---|
| Citations per year | 0,67 |
| Citation span | 2011 - 2018 (8) |
| Citation velocity | historical |
| Highly cited | No |
| Citation types | Neutral: 8 |