title: Breast biopsy and race/ethnicity among women without breast cancer.
abstract: BACKGROUND
  Breast biopsy is essential for definitive breast cancer diagnosis, but may also play a role in determining eligibility for breast cancer preventive measures or clinical trials. In addition, the prevalence of a history of negative breast biopsy can be viewed as an indicator of the adequacy or intensity of health care in a given population. We therefore analyzed the association of a history of breast biopsy with race/ethnicity and other factors in a cohort of women without a cancer diagnosis who completed a risk assessment form for participation in the Study of Tamoxifen and Raloxifene (STAR) and a sociodemographic questionnaire.
  
  
  METHODS
  Subjects were recruited at our large, urban teaching hospital. We developed a logistic regression model with biopsy (ever/never) as the outcome and age, race/ethnicity, educational attainment, and insurance coverage as the independent variables.
  
  
  RESULTS
  Among 805 unaffected predominantly minority subjects, white women were more than three times as likely as black and Hispanic women (OR=3.3, 95% CI 1.9-5.9), and insured women were twice as likely as uninsured women (OR=2.0, 95% CI 1.4-2.9) to have had a biopsy. Biopsy results were also associated with race/ethnicity.
  
  
  CONCLUSIONS
  We view these observations as hypothesis-generating rather than definitive. If confirmed, the associations we observed between negative biopsies and insurance status may reflect disparities in the timeliness and effectiveness of follow-up of suspicious lesions found via mammography. Our findings may also be relevant to the well-known association of breast cancer stage at diagnosis with low income and minority race/ethnicity.
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA.
authors.forename: Judith S
authors.initials: JS
authors.lastname: Jacobson
authors.forename: Victor R
authors.initials: VR
authors.lastname: Grann
authors.forename: Dawn
authors.initials: D
authors.lastname: Hershman
authors.forename: Andrea B
authors.initials: AB
authors.lastname: Troxel
authors.forename: Huiling
authors.initials: H
authors.lastname: Li
authors.forename: Alfred I
authors.initials: AI
authors.lastname: Neugut
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D001706:Biopsy / Q000706:statistics & numerical data*; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000208:ethnology* / Q000517:prevention & control; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007348:Insurance, Health; D016015:Logistic Models; D008875:Middle Aged; D008913:Minority Groups / Q000706:statistics & numerical data*; D018570:Risk Assessment; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D044465:White People / Q000706:statistics & numerical data