Self-Detection Remains a Key Method of Breast Cancer Detection for U.S. Women

Roth, Mara Y.; Elmore, Joann G.; Yi‐Frazier, Joyce P.; Reisch, Lisa M.; Oster, Natalia V.; Miglioretti, Diana L.

doi:10.1089/jwh.2010.2493

Cited by 50 publications

(34 citation statements)

References 22 publications

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“…Prior comparisons of symptomatic versus screen-detected breast cancers have often included both women with a recent prior screening history and women without a recent prior history, and these studies are not directly comparable to ours (10–12,22–27). Several studies have examined the disparities with respect to interval breast cancer as an outcome on either tumor biological factors or health care quality factors (13,14,28–32), but none of these studies provided a comprehensive picture of the multiple factors contributing to the disparity in symptomatic detection.…”

Section: Discussionmentioning

confidence: 70%

Racial and Ethnic Disparity in Symptomatic Breast Cancer Awareness despite a Recent Screen: The Role of Tumor Biology and Mammography Facility Characteristics

Mortel

Rauscher

Murphy

et al. 2015

Cancer Epidemiology, Biomarkers &Amp; Prevention

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BACKGROUND In a racially and ethnically diverse sample of recently diagnosed urban breast cancer patients, we examined associations of patient, tumor biology and mammography facility characteristics on the probability of symptomatic discovery of their breast cancer despite a recent prior screening mammogram. METHODS In the Breast Cancer Care in Chicago study, self-reports at interview were used to define patients as having a screen-detected breast cancer or having symptomatic awareness despite a recent screening mammogram (SADRS), in the past one or two years. Patients with symptomatic breast cancer who did not report a recent prior screen were excluded from these analyses. Characteristics associated with more aggressive disease (estrogen and progesterone receptor negative status and higher tumor grade) were abstracted from medical records. Mammogram facility characteristics that might indicate aspects of screening quality were defined and controlled for in some analyses. RESULTS SADRS was more common among nH Black and Hispanic than nH White patients (36% and 42% vs. 25%, respectively, p=0.0004). SADRS was associated with ER/PR negative and higher grade disease. Patients screened at sites that relied on dedicated radiologists, and sites that were breast imaging centers of excellence were less likely to report SADRS. Tumor and facility factors together accounted for two-thirds of the disparity in SADRS (proportion mediated=70%, p=0.02). CONCLUSION Facility resources and tumor aggressiveness explain much of the racial/ethnic disparity in symptomatic breast cancer among recently screened patients. IMPACT: A more equitable distribution of high quality screening would ameliorate but not eliminate this disparity.

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Section: Discussionmentioning

confidence: 70%

Racial and Ethnic Disparity in Symptomatic Breast Cancer Awareness despite a Recent Screen: The Role of Tumor Biology and Mammography Facility Characteristics

Mortel

Rauscher

Murphy

et al. 2015

Cancer Epidemiology, Biomarkers &Amp; Prevention

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“…Patient self-detection was no longer significantly associated with BC subtype in multivariate analysis (which included adjustment for SES factors, race and education), suggesting that the associations with mode of breast tumor detection may have been confounded by SES [39]. Recent data has shown that a large proportion (approximately 60%) of BC cases in the U.S. is discovered through self-detection, particularly among low-SES women [40,39]. In our study, 42.9% of BC patients reported self-detection and HER2-expressing and TNBC subtypes were 2–3 times more likely to be self-detected than the luminal A subtype.…”

Section: Discussionmentioning

confidence: 99%

Associations between sociodemographic and clinicopathological factors and breast cancer subtypes in a population-based study

Llanos

Chandwani

Bandera

et al. 2015

Cancer Causes Control

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Purpose This study examines the factors distinguishing breast cancer (BC) subtypes. Methods We examined subtypes in 629 women with invasive BC, diagnosed from 2006–2012 and enrolled in an epidemiological study in New Jersey. Using molecular characteristics from pathology reports, BCs were categorized as luminal A, luminal B, non-luminal HER2-expressing, or triple-negative breast cancer [TNBC] subtypes. Multinomial logistic models (luminal A as referent) were used to describe BC subtype associations. Results Women with luminal B tumors were more likely to be younger at diagnosis (Odds ratio [OR] 1.8, 95% confidence interval [CI] 1.0–3.4) and to have higher grade (OR 2.6, 95% CI 1.5–4.7), larger (OR 1.9, 95% CI 1.0–3.6), and Ki67 positive tumors (OR 2.1, 95% CI 1.1–4.0). Women with non-luminal HER2-expressing BCs were more likely to have higher grade tumors (OR 14.5, 95% CI 5.3–39.7). Women with TNBCs were more likely to be African American (OR 1.9, 95% CI 1.0–3.4) and to have higher grade (Or 9.7, 95% CI 5.1–18.4), larger (OR 2.2, 95% CI 1.0–4.8), and Ki67 positive (OR 2.9, 95% CI 1.6–5.2) tumors. Notably, compared to the luminal A subtype, luminal B, non-luminal HER2-expressing and triple-negative subtypes were more frequently self-detected; however, these associations were attenuated in multivariable models. Conclusions These findings suggest that some BC subtypes were associated with features denoting more aggressive phenotypes, namely higher grade, larger size, and Ki67 positivity, and possibly patient self-detection among some women. These findings highlight a need for enhanced screening, particularly among younger women, racial/ethnic minorities and lower socioeconomic subgroups.

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“…Nevertheless, the ACS (2014a) and some health care providers (Mart, 2010) continue to recommend BSE as an option for women, and at a minimum suggest that women be aware of the shape, feel, and appearance of their breasts, and/or perform monthly BSEs. Further, research suggests that, despite not being officially recommended, women still perform BSEs, with approximately 43% of breast cancers discovered by women themselves via BSE or by accident (Roth et al, 2011).…”

Section: Schlehofer and Brown-reidmentioning

confidence: 99%

Breast Health Beliefs, Behaviors, and Barriers Among Latina Permanent Resident and Migratory Farm Workers

Schlehofer

Brown-Reid

2015

Journal of Community Health Nursing

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There is a dearth of research on the breast health behaviors of migratory farm workers. This research used focus group methodology to compare the breast cancer beliefs and barriers of Latina women working as migratory farmers (n = 33) and permanent residents (n = 31). In comparison to their permanent resident counterparts, migrant farmers had low knowledge about the causes of breast cancer, and experienced significant barriers to care. Many barriers were cultural-specific, including culturally-based gender roles. These findings have significant implications for designing culturally-relevant interventions to improve access to care among this population.

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Self-Detection Remains a Key Method of Breast Cancer Detection for U.S. Women

Cited by 50 publications

References 22 publications

Racial and Ethnic Disparity in Symptomatic Breast Cancer Awareness despite a Recent Screen: The Role of Tumor Biology and Mammography Facility Characteristics

Racial and Ethnic Disparity in Symptomatic Breast Cancer Awareness despite a Recent Screen: The Role of Tumor Biology and Mammography Facility Characteristics

Associations between sociodemographic and clinicopathological factors and breast cancer subtypes in a population-based study

Breast Health Beliefs, Behaviors, and Barriers Among Latina Permanent Resident and Migratory Farm Workers

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