title: Breast cancer treatment delays in a majority minority community: is there a difference?
abstract: OBJECTIVE
  Recent studies from large nationwide cancer databases have consistently shown that Hispanic women with breast cancer have delays in treatment initiation compared with non-Hispanic white women. However, time to treatment initiation has not been studied in a community where Hispanics are the majority.
  
  
  METHODS
  We conducted a retrospective, observational study of 362 female patients with breast cancer treated at a large National Cancer Institute (NCI) -designated cancer center with a largely Hispanic population. We examined the relationship between race/ethnicity and time from mammogram to biopsy as well as time from biopsy to treatment initiation using Kaplan-Meier analyses and multivariable Cox proportional hazards regression.
  
  
  RESULTS
  Half of the female patients with breast cancer were of Hispanic descent (50.0%; n = 181). Hispanic patients were more likely to be obese, have an Eastern Cooperative Oncology Group functional status ≥ 1, and have higher histologic grade disease (all P ≤ .05); no differences in American Joint Committee on Cancer stage at diagnosis were observed. After comprehensive adjustment for demographic and clinical characteristics, we found no significant differences between Hispanic versus non-Hispanic white patients in time from mammogram to biopsy (hazard ratio [HR], 0.91; 95% CI, 0.68 to 1.21) or time from biopsy to treatment (HR, 1.13; 95% CI, 0.69 to 1.88).
  
  
  CONCLUSIONS
  Hispanic women and Non-Hispanic white women with breast cancer treated at an NCI-designated cancer center had similar times to biopsy and treatment initiation. These findings suggest that in majority minority communities with large cancer centers, racial disparities can be reduced. With a growing Hispanic population throughout the United States, future studies should examine the long-term impact on improved breast cancer survival in this population.
authors.affiliation: University of Texas Health Science Center at San Antonio; and Cancer Therapy and Research Center, San Antonio, TX parsonsh@uthscsa.edu.
authors.forename: Helen M
authors.initials: HM
authors.lastname: Parsons
authors.affiliation: University of Texas Health Science Center at San Antonio; and Cancer Therapy and Research Center, San Antonio, TX.
authors.forename: Kate I
authors.initials: KI
authors.lastname: Lathrop
authors.affiliation: University of Texas Health Science Center at San Antonio; and Cancer Therapy and Research Center, San Antonio, TX.
authors.forename: Susanne
authors.initials: S
authors.lastname: Schmidt
authors.affiliation: University of Texas Health Science Center at San Antonio; and Cancer Therapy and Research Center, San Antonio, TX.
authors.forename: Marcela
authors.initials: M
authors.lastname: Mazo-Canola
authors.affiliation: University of Texas Health Science Center at San Antonio; and Cancer Therapy and Research Center, San Antonio, TX.
authors.forename: Jessica
authors.initials: J
authors.lastname: Trevino-Jones
authors.affiliation: University of Texas Health Science Center at San Antonio; and Cancer Therapy and Research Center, San Antonio, TX.
authors.forename: Heather
authors.initials: H
authors.lastname: Speck
authors.affiliation: University of Texas Health Science Center at San Antonio; and Cancer Therapy and Research Center, San Antonio, TX.
authors.forename: Anand B
authors.initials: AB
authors.lastname: Karnad
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D008913:Minority Groups / Q000706:statistics & numerical data*; D044465:White People