title: Receipt of surgical treatment in US women with early stage breast cancer: does place of birth matter?
abstract: BACKGROUND
  While effects of age, race, place of residence, and marital status on receipt of treatment among female breast cancer patients have been well documented, place of birth is a relatively less studied factor. The purpose of our study was to assess the relationship between birth place and type of surgery performed for early-stage breast cancer among US women of different racial and ethnic backgrounds.
  
  
  METHODS
  Eligible cases (n=119,560) were selected from the SEER registries for the period 2004-2009. US-born and foreign-born patients of different racial/ethnic groups were compared to US-born non-Hispanic Whites (NHW) with respect to receipt of breast conserving surgery (BCS) or mastectomy. Results of multivariable logistic regression analyses were expressed as adjusted odds ratios (OR) and the corresponding 95% confidence intervals (CI).
  
  
  RESULTS
  The proportion of BCS was highest in foreign-born Whites (62.5%) and lowest in foreign-born Asians (50.3%). Relative to US-born NHW, BCS was more common in foreign-born Whites (OR=1.21. 95% CI: 1.15-1.28) and foreign-born Blacks (OR=1.21. 95% CI: 1.15-1.28). In contrast, foreign-born Asians received less BCS compared to both US-born NHW (OR=.76, 95% CI: .72-0.80) and US-born Asians (OR=.74, 95% CI: .64-.86).
  
  
  CONCLUSIONS
  Foreign-born Asian breast cancer patients are less likely to receive BSC compared to US-born Whites or Asian-Americans, whereas foreign-born Whites and foreign-born Blacks are more likely to receive BCS than US-born Whites. Further studies are needed to understand cultural and or health systems factors that may explain these observations.
authors.forename: Saurabh
authors.initials: S
authors.lastname: Chavan
authors.forename: Michael
authors.initials: M
authors.lastname: Goodman
authors.forename: Ahmedin
authors.initials: A
authors.lastname: Jemal
authors.forename: Stacey A
authors.initials: SA
authors.lastname: Fedewa
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D001213:Asian / Q000706:statistics & numerical data; D001943:Breast Neoplasms / Q000208:ethnology* / Q000601:surgery*; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D015412:Mastectomy, Segmental / Q000706:statistics & numerical data*; D008875:Middle Aged; D044468:Native Hawaiian or Pacific Islander / Q000208:ethnology / Q000706:statistics & numerical data; D016017:Odds Ratio; D018426:SEER Program; D014481:United States; D044465:White People / Q000706:statistics & numerical data