Breast Cancer Treatment among African American Women in North St. Louis, Missouri

Connors, Shahnjayla K.; Goodman, Melody S.; Noel, Lailea; Chavakula, Neeraja N.; Butler, Dwayne; Kenkel, Sandi; Oliver, Cheryl; McCullough, Isaac; Gehlert, Sarah

doi:10.1007/s11524-014-9884-5

Cited by 10 publications

(7 citation statements)

References 66 publications

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“…We likewise found no evidence that interprofessional team meetings included navigators. Our findings support previous research showing the failure to ensure continuity of service between radiation oncology and medical oncology and surgery may interfere with the receipt of services [ 31 ]. In comparing the women’s stories about treatment and that of the attending physicians as recorded in the patient records, we found only two instances in which providers recorded conversations with women, and neither indicated shared decision making.…”

Section: Discussionsupporting

confidence: 89%

“…Participant data were extracted from electronic medical record (EMR) programs used at the academic medical system: allscripts, used by outpatient clinics, and ClinDesk, used by inpatient clinics. The EMRs were searched for individual characteristics (age, income at time of diagnosis), clinical characteristics (tumor histology, stage, grade, hormone receptor status), and curative breast cancer treatment characteristics (modalities, start dates, end dates, explanations of treatment decisions, and/or delays) [ 31 ]. The types of EMR documents analyzed included pathology reports, treatment consultations, physician/nurse notes, operative summaries, and treatment summaries.…”

Section: Methodsmentioning

confidence: 99%

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Improving breast cancer services for African-American women living in St. Louis

Noel

Connors

Goodman

et al. 2015

Breast Cancer Res Treat

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A mixed methods, community-based research study was conducted to understand how provider-level factors contribute to the African-American and white disparity in breast cancer mortality in a lower socioeconomic status area of North St. Louis. This study used mixed methods including: (1) secondary analysis of Missouri Cancer Registry data on all 885 African-American women diagnosed with breast cancer from 2000 to 2008 while living in the geographic area of focus; (2) qualitative interviews with a subset of these women; (3) analysis of data from electronic medical records of the women interviewed; and (4) focus group interviews with community residents, patient navigators, and other health care professionals. 565 women diagnosed with breast cancer from 2000 to 2008 in the geographic area were alive at the time of secondary data analysis; we interviewed (n = 96; 17 %) of these women. Provider-level obstacles to completion of prescribed treatment included fragmented navigation (separate navigators at Federally Qualified Health Centers, surgical oncology, and medical oncology, and no navigation services in surgical oncology). Perhaps related to the latter, women described radiation as optional, often in the same words as they described breast reconstruction. Discontinuous and fragmented patient navigation leads to failure to associate radiation therapy with vital treatment recommendations. Better integrated navigation that continues throughout treatment will increase treatment completion with the potential to improve outcomes in African Americans and decrease the disparity in mortality.

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Section: Discussionsupporting

confidence: 89%

Section: Methodsmentioning

confidence: 99%

Improving breast cancer services for African-American women living in St. Louis

Noel

Connors

Goodman

et al. 2015

Breast Cancer Res Treat

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“…Estatísticas apontam aumento progressivo tanto nos países desenvolvidos quanto nos em desenvolvimento e indicaram que em 2016 seriam 57.960 novos casos no Brasil (1) . Felizmente com diagnóstico precoce e tratamento adequado as chances de cura estão gradativamente aumentando (3)(4) .…”

Section: Abstract: Breast Cancer Histologty Immunohistochemistryunclassified

Perfil histológico e imuno-histoquímico das pacientes com câncer de mama operadas no Hospital Santa Casa de Curitiba no período de 2014 e 2015

Raffo

Hubie

Zanini

et al. 2018

Arq Med Hosp Fac Cienc Med Santa Casa São Paulo

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Objetivos: Identificar tipo histológico e perfil imuno-histoquímico das pacientes operadas por câncer de mama no Hospital Santa Casa de Curitiba. Correlacionar se os tipos histológicos mais agressivos são também de pior prognóstico imuno-histoquímico. Métodos: Estudo retrospectivo, observacional e analítico com 26 pacientes, no qual foram avaliadas as variáveis: sexo, idade, histologia, painel imuno-histoquímico (luminal A, luminal B, HER2 positivo e triplo negativo). Resultados: O sexo mais prevalente foi o feminino (96,2%), a média de idade foi 58 anos, o tipo histológico mais encontrado foi carcinoma ductal invasor (57,7%). No painel imuno-histoquímico a prevalência foi do subtipo luminal A (53,8%) seguidos pelos luminal B (30,8%), HER2 positivo (7,7%) e triplo negativo (7,7%). Na análise da relação histológica e imuno-histoquímica 57,1% dos carcinomas ductais invasores são luminais A e o carcinoma pouco diferenciado é triplo negativo. Os mistos foram distribuídos em luminal A (66,7%) e luminal B (33,3%). Os mucinosos dividiram-se igualmente em luminal A, luminal B e triplo negativo. O lobular invasor teve distribuição igual entre luminal A e B. Conclusões: O sexo feminino foi o mais prevalente, a média de idade apresentou um platô acima do encontrado na literatura, o tipo histológico mais incidente nas pacientes acompanhadas foi o carcinoma ductal invasor. No painel imuno-histoquímico a prevalência foi do subtipo luminal A, seguidos pelos luminal B, HER2 positivo e triplo negativo. Os tipos histológicos menos agressivos são mais comuns e também apresentam perfil imuno-histoquímico de melhor prognóstico e os mais agressivos são de pior prognóstico e menos responsivos aos tratamentos.

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“…Understanding characteristics that are associated with the receipt of high quality breast cancer care, such as that reported for NCI-CCCs, are essential for identifying and implementing the best practices needed to ensure equitable access to breast reconstruction for all women (Onega et al 2014 ). Previous studies at Siteman Cancer Center focused on specific patient groups and utilized smaller sample sizes (Connors et al 2014 ; Elmore et al 2012 ; Sharma et al 2015 ). The purpose of this study was to utilize a large multi-year sample to conduct a comprehensive examination of the rate and determinants of breast reconstruction at Siteman Cancer Center, a NCI-CCC located in Saint Louis, Missouri.…”

Section: Introductionmentioning

confidence: 99%

Breast reconstruction after mastectomy at a comprehensive cancer center

et al. 2016

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BackgroundBreast reconstruction after mastectomy is an integral part of breast cancer treatment that positively impacts quality of life in breast cancer survivors. Although breast reconstruction rates have increased over time, African American women remain less likely to receive breast reconstruction compared to Caucasian women. National Cancer Institute-designated Comprehensive Cancer Centers, specialized institutions with more standardized models of cancer treatment, report higher breast reconstruction rates than primary healthcare facilities. Whether breast reconstruction disparities are reduced for women treated at comprehensive cancer centers is unclear. The purpose of this study was to further investigate breast reconstruction rates and determinants at a comprehensive cancer center in St. Louis, Missouri.MethodsSociodemographic and clinical data were obtained for women who received mastectomy for definitive surgical treatment for breast cancer between 2000 and 2012. Logistic regression was used to identify factors associated with the receipt of breast reconstruction.ResultsWe found a breast reconstruction rate of 54 % for the study sample. Women who were aged 55 and older, had public insurance, received unilateral mastectomy, and received adjuvant radiation therapy were significantly less likely to receive breast reconstruction. African American women were 30 % less likely to receive breast reconstruction than Caucasian women.ConclusionThese findings suggest that racial disparities in breast reconstruction persist in comprehensive cancer centers. Future research should further delineate the determinants of breast reconstruction disparities across various types of healthcare institutions. Only then can we develop interventions to ensure all eligible women have access to breast reconstruction and the improved quality of life it affords breast cancer survivors.

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Breast Cancer Treatment among African American Women in North St. Louis, Missouri

Cited by 10 publications

References 66 publications

Improving breast cancer services for African-American women living in St. Louis

Improving breast cancer services for African-American women living in St. Louis

Perfil histológico e imuno-histoquímico das pacientes com câncer de mama operadas no Hospital Santa Casa de Curitiba no período de 2014 e 2015

Breast reconstruction after mastectomy at a comprehensive cancer center

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