Trends in breast conserving surgery among Asian Americans and Pacific Islanders, 1992-2000.
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.
Goel
Mita Sanghavi
MS
Division of General Internal Medicine, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA. mgoel@nmff.org
Burns
Risa B
RB
Phillips
Russell S
RS
Davis
Roger B
RB
Ngo-Metzger
Quyen
Q
McCarthy
Ellen P
EP
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