Racial disparities in postmastectomy breast reconstruction: National trends in utilization from 2005 to 2014

Epstein, Sherise; Tran, Bich; Cohen, Justin B.; Lin, Samuel J.; Singhal, Dhruv; Lee, Bernard T.

doi:10.1002/cncr.31395

Cited by 71 publications

(61 citation statements)

References 45 publications

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“…5 Using the American College of Surgeons National Surgical Quality Improvement Program database, Epstein et al reported that the use of postmastectomy reconstruction was significantly lower for AI/AN women compared with NHW women. 6 In addition to diagnostic and treatment disparities, breast cancer diagnosed among AI/AN women also may be more inherently aggressive. Using the SEER database, Chen and Li reported that the risk of triple-negative breast cancer was significantly increased among AI/AN women compared with NHW women.…”

Section: Discussionmentioning

confidence: 99%

“…Javid et al reported that the use of surveillance after breast cancer treatment was significantly reduced in AI/AN women compared with NHW women 5 . Using the American College of Surgeons National Surgical Quality Improvement Program database, Epstein et al reported that the use of postmastectomy reconstruction was significantly lower for AI/AN women compared with NHW women 6 …”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] Previous studies have shown that AI/AN women are more likely to be diagnosed at younger ages and with later stages of breast cancer and receive less guideline-concordant and optimal treatment compared with non-Hispanic white (NHW) women. 2,[4][5][6][7][8] Treatment barriers, including a lack of cancer care at local clinics and a long distance to travel, impact the quality of life of AI/AN survivors of breast cancer. 9 The survival rates of AI/AN women with breast cancer are worse compared with those of NHW women.…”

Section: Introductionmentioning

confidence: 99%

“…Breast cancer is one of the most common causes of cancer mortality for all women, including American Indian and Alaska Native (AI/AN) women 1‐3 . Previous studies have shown that AI/AN women are more likely to be diagnosed at younger ages and with later stages of breast cancer and receive less guideline‐concordant and optimal treatment compared with non‐Hispanic white (NHW) women 2,4‐8 . Treatment barriers, including a lack of cancer care at local clinics and a long distance to travel, impact the quality of life of AI/AN survivors of breast cancer 9 .…”

Section: Introductionmentioning

confidence: 99%

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Genomic expression assay testing among American Indian and Alaska Native women with breast cancer

Marmor

Longacre

Altman

et al. 2020

Cancer

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BACKGROUND: Breast cancer is one of the most common causes of cancer mortality for all women, including American Indian and Alaska Native (AI/AN) women. The use of the 21-gene recurrence score (RS) appears to be predictive of the benefit of chemotherapy for women with estrogen receptor (ER)-positive breast cancer. The objective of the current study was to compare RS testing between AI/AN and non-Hispanic White (NHW) women with breast cancer. Methods: The Surveillance, Epidemiology, and End Results program was used to identify women with ER-positive breast cancer from 2004 through 2015. Multivariable logistic regression was used to evaluate factors associated with RS use, with high-risk RS, and with chemotherapy use among those with a high-risk RS. Results: A total of 363,387 NHW patients and 1951 AI/AN patients with ER-positive breast cancer were identified. AI/AN women were found to be less likely to undergo RS testing and, when tested, were more likely to have a high-risk RS. In the multivariable logistic regression analysis, AI/AN women were found to be significantly more likely to have a high-risk RS (odds ratio,1.28; 95% confidence interval, 1.01-1.66). Among untested women, chemotherapy use was higher for AI/AN women; however, the use of chemotherapy was not found to be significantly different between the groups with a high-risk RS. Using Cox proportional hazards models, AI/AN race was found to be significantly associated with worse overall survival. Conclusions: AI/AN women were less likely to undergo RS testing compared with NHW women and were more likely to have a high-risk RS. Reversing the disparity in genomic expression assay testing is critical to ensure guideline-based breast cancer treatment and improve survival rates for AI/AN women with breast cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Genomic expression assay testing among American Indian and Alaska Native women with breast cancer

Marmor

Longacre

Altman

et al. 2020

Cancer

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“…in public health policy may be correlated with recent measured reductions in breast reconstruction disparities. 3,4 In contrast to breast reconstruction, investigation into disparities within facial plastic and reconstructive surgery literature has been limited, including examination of rhinoplasty outcomes. Patient-reported outcomes (PROMs) are increasingly seen as significant to assessing treatment success in facial aesthetic and reconstructive surgery, including rhinoplasty.…”

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confidence: 99%

Relationship of Sociodemographic Factors and Outcomes in Functional Rhinoplasty

et al. 2019

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The objective of this article was to compare the effect of such sociodemographic factors as gender, age, marital status, employment status, race, and income on short- and long-term rhinoplasty outcomes using a validated disease-specific instrument—Nasal Obstruction Symptom Evaluation (NOSE) scale, as well as complication and revision rates. Patients who underwent a functional (+/− cosmetic) rhinoplasty with the senior author between January, 1 2012, and September 9, 2017, and had both a preoperative and at least one postoperative NOSE score, were included in the study. Sociodemographic variables of binary gender, age, marital status, employment status, race, and income based on zip code were collected. The primary outcomes were the differences between the preoperative and postoperative NOSE scores with short-term (less than 3 months) and longer-term (greater than 3 months) follow-up. Secondary outcomes were general complications and specifically revision surgery. Standard descriptive statistics, as well as univariable linear and logistic regressions, were conducted with each outcome measure. A total of 341 patients were included in this study. No individual patient-level variables were found to significantly affect the short- or longer-term average change in NOSE scores, although older age trended toward significance in longer-term average change in NOSE scores (p = 0.07). No factors significantly affected the rate of complications or revision surgery in this cohort. The authors found improvement in NOSE scores after rhinoplasty was not related to factors of age, gender, race, employment status, income, and marital status. This cohort also did not demonstrate differential rates in complications or revision surgery based on sociodemographic variables.

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Factors Associated With State-Specific Medicaid Expansion and Receipt of Autologous Breast Reconstruction Among Patients Undergoing Mastectomy

et al. 2021

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Key Points Question What is the association between the Patient Protection and Affordable Care Act’s state-specific Medicaid expansion and the use of autologous breast reconstruction? Findings In this national cross-sectional study of 45 850 patients who underwent mastectomy and 9215 patients who received autologous breast reconstruction, although the proportion of patients undergoing autologous breast reconstruction increased from 18.1% to 23.0% over the study period, Medicaid expansion was associated with significantly decreased odds of undergoing reconstruction for African American, Hispanic, Asian, and Native American patients. Meaning Medicaid expansion was associated with decreased odds of autologous reconstruction for African American, Hispanic, and other patients with minority race/ethnicity.

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Racial disparities in postmastectomy breast reconstruction: National trends in utilization from 2005 to 2014

Abstract: The use of postmastectomy breast reconstruction is steadily rising in the United States. Racial disparities persist, but progress has been made. Further efforts are needed to reduce racial disparities. Cancer 2018;124:2774-2784. © 2018 American Cancer Society.

Cited by 71 publications

References 45 publications

Genomic expression assay testing among American Indian and Alaska Native women with breast cancer

Genomic expression assay testing among American Indian and Alaska Native women with breast cancer

Relationship of Sociodemographic Factors and Outcomes in Functional Rhinoplasty

Factors Associated With State-Specific Medicaid Expansion and Receipt of Autologous Breast Reconstruction Among Patients Undergoing Mastectomy

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