Factors associated with contralateral preventive mastectomy

Danny Yakoub, Eli Avisar, Tulay Sengul, Feng Miao, Stacey L. Tannenbaum, Margaret M Byrne, Frederick L Moffat, Alan Livingstone, Dido Franceschi

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Introduction: Contralateral prophylactic mastectomy (CPM) is an option for women who wish to reduce their risk of breast cancer or its local recurrence. There is limited data on demographic differences among patients who choose to undergo this procedure.

Methods: The population-based Florida cancer registry, Florida’s Agency for Health Care Administration data, and US census data were linked and queried for patients diagnosed with invasive breast cancer from 1996 to 2009. The main outcome variable was the rate of CPM. Primary predictors were race, ethnicity, socioeconomic status (SES), marital status and insurance status.

Results: Our population was 91.1% White and 7.5% Black; 89.1% non-Hispanic and 10.9% Hispanic. Out of 21,608 patients with a single unilateral invasive breast cancer lesion, 837 (3.9%) underwent CPM. Significantly more White than Black (3.9% vs 2.8%; P,0.001) and more Hispanic than non-Hispanic (4.5% vs 3.8%; P=0.0909) underwent CPM. Those in the highest SES category had higher rates of CPM compared to the lowest SES category (5.3% vs 2.9%; P,0.001). In multivariate analyses, Blacks compared to Whites (OR =0.59, 95% CI =0.42–0.83, P=0.002) and uninsured patients compared to privately insured (OR =0.60, 95% CI =0.36–0.98, P=0.043) had significantly less CPM.

Conclusion: CPM rates were significantly different among patients of different race, socioeconomic class, and insurance coverage. This observation is not accounted for by population distribution, incidence or disease stage. More in-depth study of the causes of these disparities in health care choice and delivery is critically needed.

Original languageEnglish
Pages (from-to)1-8
Number of pages8
JournalBreast Cancer: Targets and Therapy
Volume7
DOIs
StatePublished - Jan 7 2015

Fingerprint

Mastectomy
Social Class
Insurance Coverage
Hispanic Americans
Demography
Breast Neoplasms
Delivery of Health Care
Marital Status
Censuses
Prophylactic Mastectomy
Population
Registries
Multivariate Analysis
Recurrence
Incidence
Neoplasms

Keywords

  • Bilateral mastectomy
  • Breast cancer
  • Cancer disparities
  • Ethnic factors
  • Social factors

ASJC Scopus subject areas

  • Oncology

Cite this

Factors associated with contralateral preventive mastectomy. / Yakoub, Danny; Avisar, Eli; Sengul, Tulay; Miao, Feng; Tannenbaum, Stacey L.; Byrne, Margaret M; Moffat, Frederick L; Livingstone, Alan; Franceschi, Dido.

In: Breast Cancer: Targets and Therapy, Vol. 7, 07.01.2015, p. 1-8.

Research output: Contribution to journalArticle

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abstract = "Introduction: Contralateral prophylactic mastectomy (CPM) is an option for women who wish to reduce their risk of breast cancer or its local recurrence. There is limited data on demographic differences among patients who choose to undergo this procedure.Methods: The population-based Florida cancer registry, Florida’s Agency for Health Care Administration data, and US census data were linked and queried for patients diagnosed with invasive breast cancer from 1996 to 2009. The main outcome variable was the rate of CPM. Primary predictors were race, ethnicity, socioeconomic status (SES), marital status and insurance status.Results: Our population was 91.1{\%} White and 7.5{\%} Black; 89.1{\%} non-Hispanic and 10.9{\%} Hispanic. Out of 21,608 patients with a single unilateral invasive breast cancer lesion, 837 (3.9{\%}) underwent CPM. Significantly more White than Black (3.9{\%} vs 2.8{\%}; P,0.001) and more Hispanic than non-Hispanic (4.5{\%} vs 3.8{\%}; P=0.0909) underwent CPM. Those in the highest SES category had higher rates of CPM compared to the lowest SES category (5.3{\%} vs 2.9{\%}; P,0.001). In multivariate analyses, Blacks compared to Whites (OR =0.59, 95{\%} CI =0.42–0.83, P=0.002) and uninsured patients compared to privately insured (OR =0.60, 95{\%} CI =0.36–0.98, P=0.043) had significantly less CPM.Conclusion: CPM rates were significantly different among patients of different race, socioeconomic class, and insurance coverage. This observation is not accounted for by population distribution, incidence or disease stage. More in-depth study of the causes of these disparities in health care choice and delivery is critically needed.",
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AU - Avisar, Eli

AU - Sengul, Tulay

AU - Miao, Feng

AU - Tannenbaum, Stacey L.

AU - Byrne, Margaret M

AU - Moffat, Frederick L

AU - Livingstone, Alan

AU - Franceschi, Dido

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KW - Breast cancer

KW - Cancer disparities

KW - Ethnic factors

KW - Social factors

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