Race/Ethnicity, Primary Language, and Income Are Not Demographic Drivers of Mortality in Breast Cancer Patients at a Diverse Safety Net Academic Medical Center

Abstract

Objective. To examine the impact of patient demographics on mortality in breast cancer patients receiving care at a safety net academic medical center. Patients and Methods. 1128 patients were diagnosed with breast cancer at our institution between August 2004 and October 2011. Patient demographics were determined as follows: race/ethnicity, primary language, insurance type, age at diagnosis, marital status, income (determined by zip code), and AJCC tumor stage. Multivariate logistic regression analysis was performed to identify factors related to mortality at the end of follow-up in March 2012. Results. There was no significant difference in mortality by race/ethnicity, primary language, insurance type, or income in the multivariate adjusted model. An increased mortality was observed in patients who were single (OR = 2.36, CI = 1.28–4.37, p = 0.006), age > 70 years (OR = 3.88, CI = 1.13–11.48, p = 0.014), and AJCC stage IV (OR = 171.81, CI = 59.99–492.06, p < 0.0001). Conclusions. In this retrospective study, breast cancer patients who were single, presented at a later stage, or were older had increased incidence of mortality. Unlike other large-scale studies, non-White race, non-English primary language, low income, or Medicaid insurance did not result in worse outcomes.

Prognostic significance of marital status in breast cancer survival: A population-based study

“…A more recent study conducted in a safety net hospital reported an over 2-fold increase in breast cancer mortality in single versus married breast cancer patients [5]. However, none of these studies examined whether the marital status effects on survival differ across patient subgroups or tumor subtypes.…”

“…A growing body of evidence shows that mortality following a cancer diagnosis is higher in unmarried than married patients [ 1 – 4 ]. However, studies on the association specific to breast cancer are limited [ 5 , 6 ], despite this being the most common cancer in women. Some published reports included marital status as a covariate in multivariable analyses [ 7 – 9 ], but, to our knowledge, a focused examination of the specific effect of marital status on breast cancer survival in different racial/ethnic populations or by tumor subtype has not been reported.…”

Social Support, Insomnia, and Adherence to Cognitive Behavioral Therapy for Insomnia After Cancer Treatment

“…Stimulus control limits the activities performed in bed to sleep and sex only so as to recondition the bed to be associated with sleep as opposed to wakefulness. Sleep restriction and stimulus control can produce a temporary worsening of daytime sleepiness and discomfort and are thought to be the most difficult components for patients to adhere to (Parikh et al, 2015). Sleep hygiene serves to promote behaviors and practices that facilitate sleep and to discourage behaviors and practices that are thought to contribute to insomnia.…”

Breast Cancer in Western Iraq: Clinicopathological Single Institution Study

“…World widely; around 6.6% of all breast cancer cases were diagnosed in women less than 40 of age [3] and in USA 6.7% of patients were <40 y and 29.8% were <50 y [15]. In this study, 66 & 98 patients out of 292 (22.6% & 33.56%) were <40 & ≤40 years old respectively, and 199 patients out of 292 (68.2%) were <50 years old, where they are obviously higher than above stated word wide and USA indices, but they are compatible with Arabic study that included 8 Arabic countries 65.5% (±11) [5].…”