Is mode of breast cancer detection associated with cancer treatment in the United States?

Authors

  • K. Robin Yabroff PhD, MBA,

    Corresponding author
    1. Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
    • Applied Research Program, National Cancer Institute, Executive Plaza North, Room 4005, 6130 Executive Boulevard, MSC 7344, Bethesda, MD 20892-7344
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    • Fax: (301) 435-3710

  • Linda C. Harlan PhD, MPH,

    1. Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
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  • Limin X. Clegg PhD,

    1. Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
    2. Office of Healthcare Inspections, Office of Inspector General, U.S. Department of Veterans Affairs, Washington, District of Columbia
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  • Rachel Ballard-Barbash MD, MPH,

    1. Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
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  • Jennifer Stevens BS,

    1. Information Management Services, Inc., Silver Spring, Maryland
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  • Donald L. Weaver MD

    1. Department of Pathology, University of Vermont College of Medicine, Burlington, Vermont
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  • This article is a US government work and, as such, is in the public domain in the United States of America.

  • The authors have no potential conflicts of interest.

Abstract

BACKGROUND

The prognosis for women who have breast cancer detected by mammography is more favorable than that for women who have breast cancer detected by other methods, even after controlling for tumor characteristics. In the current study, the authors explored whether detection by mammography was associated with greater use of guideline-consistent breast cancer treatment among patients with recently diagnosed breast cancer in the United States.

METHODS

The authors evaluated the association between mode of breast cancer detection (mammography vs other) and use of guideline-consistent treatment in 1006 women aged ≥40 years who were diagnosed in 2000. These patients were sampled from the Surveillance, Epidemiology, and End Results Program as part of the Patterns of Care studies. The analyses controlled for the potential confounders of clinical, demographic, and health system characteristics in multivariate logistic regression models.

RESULTS

Breast cancer patients who were diagnosed by mammography were more likely to be aged ≥55 years, to have lower stage disease, and to be treated in larger hospitals than patients who were diagnosed by other methods (P < .05). Women whose breast cancer was diagnosed by a method other than mammography were more likely to receive guideline-consistent treatment than women who were diagnosed by mammography in unadjusted (odds ratio, 1.39; 95% confidence interval, 1.07–1.80) and multivariate analyses (odds ratio, 1.43; 95% confidence interval, 1.05–1.95).

CONCLUSIONS

The current results indicated that women who had breast cancer detected by methods other than mammography were slightly more likely to receive guideline-consistent therapy than women who had breast cancer detected by mammography. Future research exploring mode of detection, guideline-consistent treatment, and survival among patients with recently diagnosed breast cancer may inform understanding of factors associated with breast cancer prognosis. Cancer 2008. Published 2008 by the American Cancer Society.

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