title: Disparities in the surgical management of women with stage I breast cancer.
abstract: We sought to evaluate factors influencing the choice of surgery for women with early-stage breast cancer. Between 1996 and 2005, 47,837 women who were diagnosed with Stage I breast cancer underwent partial (PM) or total mastectomy (TM) in the California Cancer Registry. A total of 72.8 per cent of women underwent PM. Those treated in the most recent 5-year period were more likely to undergo PM than in the prior 5 years (76.5 vs 69.5%, P < 0.0001). PM rates increased with increasing socioeconomic status (SES): 65.1 per cent of patients in the lowest SES quintile underwent PM versus 77.2 per cent in the highest SES quintile (P < 0.0001). Forty- to 64-year-old women were more likely to receive PM compared with their older and younger counterparts (74.5 vs 71.2 and 67.0%, respectively; P < 0.0001). Asian/Pacific Islander women were least likely to undergo PM (64.0%), whereas non-Hispanic black women were most likely to undergo PM (75.0%) (P < 0.0001). On multivariate analysis, these demographic factors remained independent predictors of surgical treatment. PM rates have increased over time; however, significant differences in surgical management exist among women of different race/ethnic groups, ages, and SES. Further research is required to elucidate modifiable factors that impact the choice of surgery for women with early-stage breast cancer.
authors.affiliation: Department of Surgery, Division of Surgical Oncology, Loma Linda University School of Medicine, Loma Linda, California 92350, USA.
authors.forename: Windy
authors.initials: W
authors.lastname: Olaya
authors.forename: Jan H
authors.initials: JH
authors.lastname: Wong
authors.forename: John W
authors.initials: JW
authors.lastname: Morgan
authors.forename: Sharmila
authors.initials: S
authors.lastname: Roy-Chowdhury
authors.forename: Sharon S
authors.initials: SS
authors.lastname: Lum
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D002140:California; D015331:Cohort Studies; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D008408:Mastectomy / Q000706:statistics & numerical data*; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D018426:SEER Program; D012959:Socioeconomic Factors; D044465:White People / Q000706:statistics & numerical data