title: Symptom management after breast cancer treatment: is it influenced by patient characteristics?
abstract: OBJECTIVE
  With improved patient survival from breast cancer, more interest has evolved regarding the symptoms women experience in association with breast cancer treatments. We studied the extent to which symptoms for women with incident breast cancer are addressed by their physicians and how symptom management varies with patient characteristics.
  
  
  METHODS
  As part of the Los Angeles Women's (LAW) Study, we categorized women from a population-based study of incident breast cancer (n = 1,219) as having an unmet need if she had at least one severe symptom (any of the following: nausea/vomiting, arm problems, hot flashes, vaginal dryness, difficulty sleeping) for which she did not receive the help she wanted. Multivariable analyses predicted having any unmet need as a function of patient demographic and health characteristics.
  
  
  RESULTS
  The prevalence of unmet need varied by the type of symptom with the highest proportion of women receiving help for nausea and vomiting (0.91) and the lowest for vaginal dryness (0.48). Black women (OR = 3.61, 95% CI: [1.57, 8.31]), and Spanish-speaking Hispanic women (OR = 2.69, 95% CI: [1.22, 5.94]) were significantly more likely than white women to report an unmet need. More black and Hispanic women compared to white women cited the doctor not thinking treatment would benefit her (P = 0.02), not appreciating how much the problem bothered her (P = 0.03), not knowing about treatments (P < 0.0001), or insurance/cost barriers (P = 0.009) as reasons for her unmet need.
  
  
  CONCLUSIONS
  These results show the persistence of racial disparities in the receipt of appropriate care within the health care system.
authors.affiliation: School of Public Health, Health Services Department, University of California at Los Angeles, Los Angeles, CA 90095-1772, USA.
authors.forename: Jean
authors.initials: J
authors.lastname: Yoon
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Malin
authors.forename: Diana M
authors.initials: DM
authors.lastname: Tisnado
authors.forename: May Lin
authors.initials: ML
authors.lastname: Tao
authors.forename: John L
authors.initials: JL
authors.lastname: Adams
authors.forename: Martha J
authors.initials: MJ
authors.lastname: Timmer
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Ganz
authors.forename: Katherine L
authors.initials: KL
authors.lastname: Kahn
mesh_terms: D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000150:complications / Q000208:ethnology*; D005260:Female; D006301:Health Services Needs and Demand; D006630:Hispanic or Latino; D006801:Humans; D008875:Middle Aged; D009325:Nausea / Q000209:etiology; D010817:Physician-Patient Relations; D010820:Physicians; D012893:Sleep Wake Disorders / Q000209:etiology; D014839:Vomiting / Q000209:etiology; D044465:White People