title: Breast cancer treatment among African American women in north St. Louis, Missouri.
abstract: Similar to disparities seen at the national and state levels, African American women in St. Louis, Missouri have higher breast cancer mortality rates than their Caucasian counterparts. We examined breast cancer treatment (regimens and timing) in a sample of African American breast cancer patients diagnosed between 2000 and 2008 while residing in a North St. Louis cluster (eight zip codes) of late stage at diagnosis. Data were obtained from medical record extractions of women participating in a mixed-method study of breast cancer treatment experiences. The median time between diagnosis and initiation of treatment was 27 days; 12.2% of the women had treatment delay over 60 days. These findings suggest that treatment delay and regimens are unlikely contributors to excess mortality rates for African American women diagnosed in early stages. Conflicting research findings on treatment delay may result from the inconsistent definitions of treatment delay and variations among study populations. Breast cancer treatment delay may reduce breast cancer survival; additional research is needed to better understand the points at which delays are most likely to occur and develop policies, programs, and interventions to address disparities in treatment delay. There may also be differences in treatment-related survivorship quality of life; approximately 54% of the women in this sample treated with mastectomies received breast reconstruction surgery. Despite the high reconstruction rates, most women did not receive definitive completion. African American women have higher reconstruction complication rates than Caucasian women; these data provide additional evidence to suggest a disparity in breast reconstruction outcomes by race.
authors.affiliation: Department of Surgery, Division of Public Health Sciences, Washington University in St. Louis School of Medicine, 660 South Euclid, Campus Box 8100, St. Louis, MO, 63110, USA, connorss@wudosis.wustl.edu.
authors.forename: Shahnjayla K
authors.initials: SK
authors.lastname: Connors
authors.forename: Melody S
authors.initials: MS
authors.lastname: Goodman
authors.forename: Lailea
authors.initials: L
authors.lastname: Noel
authors.forename: Neeraja N
authors.initials: NN
authors.lastname: Chavakula
authors.forename: Dwayne
authors.initials: D
authors.lastname: Butler
authors.forename: Sandi
authors.initials: S
authors.lastname: Kenkel
authors.forename: Cheryl
authors.initials: C
authors.lastname: Oliver
authors.forename: Isaac
authors.initials: I
authors.lastname: McCullough
authors.forename: Sarah
authors.initials: S
authors.lastname: Gehlert
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000208:ethnology* / Q000401:mortality / Q000628:therapy*; D005260:Female; D054624:Health Status Disparities; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D016462:Mammaplasty; D008875:Middle Aged; D008923:Missouri / Q000453:epidemiology; D012959:Socioeconomic Factors; D015996:Survival Rate; D013997:Time Factors