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Trends in breast conserving surgery among Asian Americans and Pacific Islanders, 1992–2000

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Abstract

BACKGROUND: Breast-conserving surgery (BCS) has been the recommended treatment for early-stage breast cancer since 1990 yet many women still do not receive this procedure.

OBJECTIVE: To examine the relationship between birthplace and use of BCS in Asian-American and Pacific-Islander (AAPI) women, and to determine whether disparities between white and AAPI women persist over time.

DESIGN: Retrospective cohort study.

SETTING AND PARTICIPANTS: Women with newly diagnosed stage I or II breast cancer from 1992 to 2000 in the Surveillance, Epidemiology, and End Results program.

OUTCOME: Receipt of breast -conserving surgery for initial treatment of stage I or II breast cancer.

MAIN RESULTS: Overall, AAPI women had lower rates of BCS than white women (47% vs 59%; P<.01). Foreign-born AAPI women had lower rates of BCS than U.S.-born AAPI and white women (43% vs 56% vs 59%; P<.01). After adjustment for age, marital status, tumor registry, year of diagnosis, stage at diagnosis, tumor size, histology, grade, and hormone receptor status, foreign-born AAPI women (adjusted OR [aOR], 0.49; 95% CI, 0.32 to 0.76) and U.S.-born AAPI women (aOR, 0.77; 95% CI, 0.62 to 0.95) had lower odds of receiving BCS than white women. Use of BCS increased over time for each racial/ethnic group; however, foreign-born AAPI women had persistently lower rates of BCS than non-Hispanic white women.

CONCLUSIONS: AAPI women, especially those who are foreign born, are less likely to receive BCS than non-Hispanic white women. Of particular concern, differences in BCS use among foreign-born and U.S.-born AAPI women and non-Hispanic white women have persisted over time. These differences may reflect inequities in the treatment of early-stage breast cancer for AAPI women, particularly those born abroad.

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Author information

Authors and Affiliations

  1. Division of General Internal Medicine, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Mita Sanghavi Goel MD, MPH

  2. Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

    Risa B. Burns MD, Russell S. Phillips MD, Roger B. Davis ScD & Ellen P. McCarthy PhD, MPH

  3. Division of General Medicine and Primary Care and the Health Policy Research Center, University of California Irvine College of Medicine, Irvine, CA, USA

    Quyen Ngo-Metzger MD, MPH

Authors
  1. Mita Sanghavi Goel MD, MPH
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  2. Risa B. Burns MD
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  3. Russell S. Phillips MD
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  4. Roger B. Davis ScD
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  5. Quyen Ngo-Metzger MD, MPH
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  6. Ellen P. McCarthy PhD, MPH
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Corresponding author

Correspondence to Mita Sanghavi Goel MD, MPH.

Additional information

None of the organizations funding the investigators had a role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript.

Dr. Goel was supported by an institutional National Research Service Award (5T32PE11001-15) and by the Ryoichi Sasakawa Fund at the time this research was conducted. Dr. McCarthy is the recipient of a First Independent Research and Transition Award from the National Cancer Institute (R29 CA79052). Dr. Phillips is supported by a Mid-Career Investigator Award from the National Institutes of Health (K24 AT00589-01A1). Dr. Ngo-Metzger is supported by the National Cancer Institute Asian American Network for Cancer Awareness, Research and Training (U01 CA86322).

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Goel, M.S., Burns, R.B., Phillips, R.S. et al. Trends in breast conserving surgery among Asian Americans and Pacific Islanders, 1992–2000. J GEN INTERN MED 20, 604–611 (2005). https://doi.org/10.1007/s11606-005-0107-3

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  • DOI: https://doi.org/10.1007/s11606-005-0107-3

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