title: Trends in breast conserving surgery among Asian Americans and Pacific Islanders, 1992-2000.
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.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Women with newly diagnosed stage I or II breast cancer from 1992 to 2000 in the Surveillance, Epidemiology, and End Results program.
  
  
  RESULTS
  Receipt of breast -conserving surgery for initial treatment of stage I or II breast cancer.
  
  
  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.
authors.affiliation: Division of General Internal Medicine, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA. mgoel@nmff.org
authors.forename: Mita Sanghavi
authors.initials: MS
authors.lastname: Goel
authors.forename: Risa B
authors.initials: RB
authors.lastname: Burns
authors.forename: Russell S
authors.initials: RS
authors.lastname: Phillips
authors.forename: Roger B
authors.initials: RB
authors.lastname: Davis
authors.forename: Quyen
authors.initials: Q
authors.lastname: Ngo-Metzger
authors.forename: Ellen P
authors.initials: EP
authors.lastname: McCarthy
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D001208:Asia / Q000208:ethnology; D001213:Asian / Q000706:statistics & numerical data*; D001943:Breast Neoplasms / Q000208:ethnology* / Q000601:surgery / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental / Q000639:trends*; D008875:Middle Aged; D044468:Native Hawaiian or Pacific Islander / Q000706:statistics & numerical data*; D009367:Neoplasm Staging; D018426:SEER Program; D014481:United States