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Original Article
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Racial/ethnic variation in clinical presentation, treatment, and survival among breast cancer patients under age 35†
Article first published online: 18 DEC 2002
DOI: 10.1002/cncr.11051
Copyright © 2003 American Cancer Society
Additional Information
How to Cite
Shavers, V. L., Harlan, L. C. and Stevens, J. L. (2003), Racial/ethnic variation in clinical presentation, treatment, and survival among breast cancer patients under age 35. Cancer, 97: 134–147. doi: 10.1002/cncr.11051
- †
This article is a US Government work and, as such, is in the public domain in the United States of America.
Publication History
- Issue published online: 18 DEC 2002
- Article first published online: 18 DEC 2002
- Manuscript Accepted: 7 AUG 2002
- Manuscript Revised: 2 AUG 2002
- Manuscript Received: 17 JUN 2002
- Abstract
- Article
- References
- Cited By
Keywords:
- breast cancer;
- young women;
- race;
- ethnicity;
- treatment;
- clinical characteristics;
- survival;
- health disparities
Abstract
BACKGROUND
The age specific breast cancer incidence rate for African-American women under age 35 is more than twice the rate for white women of similar age, and the mortality rate is more than three times higher. To determine factors that may explain racial/ethnic variation in outcomes among young women diagnosed with breast cancer, the authors examined the clinical presentation, treatment, and survival of African-American, Hispanic, and white women under age 35 years.
METHODS
Surveillance, Epidemiology, and End Results (SEER) Program data for 1990–1998 and SEER Patterns of Care data for 1990, 1991, and 1995 were used for this analysis. Multivariate logistic regression analyses were performed to examine factors associated with the receipt of selected breast cancer treatments. Kaplan–Meier survival analyses and Cox proportional hazards regression analyses were used to examine 5-year overall survival and disease-specific survival.
RESULTS
The authors found racial/ethnic variation in clinical presentation, treatment, and survival. Both African-American and Hispanic women presented with higher disease stage and a higher prevalence of adverse prognostic indicators compared to white women. African-American and Hispanic women received cancer-directed surgery and radiation less frequently after undergoing breast-conserving surgery. Racial/ethnic differences in clinical presentation and treatment were associated with poorer overall survival in unadjusted analyses. African-American and Hispanic women also had poorer overall survival after controlling for clinical and demographic characteristics and type of treatment.
CONCLUSIONS
Future research studies should further examine the factors that influence racial/ethnic differences in incidence, clinical presentation, and treatment differentials among young women diagnosed with breast cancer. A better understanding of these factors will facilitate the development of strategies to help eliminate this health disparity. Cancer 2003;97:134–47. Published 2003 by the American Cancer Society.
DOI 10.1002/cncr.11051