title: Trends in use of contralateral prophylactic mastectomy by racial/ethnic group and ER/PR status among patients with breast cancer: A SEER population-based study.
abstract: While differences in CPM use between White and Black patients are well known, it is not clear whether CPM use differs by estrogen/progesterone receptor (ER/PR) status of tumors and whether racial/ethnic differences in the use are affected by ER/PR status, which varies between racial groups. The purpose of this study was to investigate whether CPM usage differs by racial/ethnic group and ER/PR status among patients in the Surveillance, Epidemiology, and End Results (SEER) data.
  
  
  
  The study subjects were women with histologically confirmed unilateral breast cancer who underwent breast surgery between 1998 and 2011. Age-adjusted CPM use as a proportion of all surgically treated patients or all patients who had mastectomy was analyzed by racial/ethnic group, tumor behavior, and ER/PR status. Temporal trends in age-adjusted CPM use were presented by ER/PR status and racial/ethnic group.
  
  
  
  The analyses stratified by ER/PR status showed significant racial/ethnic differences in age-adjusted CPM use with non-Hispanic White and non-Hispanic Asian/Pacific Islander (API) patients having the most and least CPM use. Age-adjusted CPM use was significantly higher for ER+/PR+ tumors than ER-/PR- ones for each race/ethnicity group among patients with mastectomy. However, among patients with any breast surgeries, the only difference was a higher proportion of CPM use for ER-/PR- tumors (8.6%) than ER+/PR+ tumors (8.0%) in non-Hispanic Whites. CPM use has increased over time in all racial/ethnic groups despite ER/PR status.
  
  
  
  CPM usage was lower not only in non-Hispanic Blacks, but also in non-Hispanic API and Hispanic patients compared to non-Hispanic White patients. CPM usage tended to be higher for ER+/PR+ tumors, but the results varied when different denominators (all mastectomies vs. all breast surgeries) were used.
authors.affiliation: John P. Murtha Cancer Center, Walter Reed National Military Medical Center, Bethesda, MD, United States.
authors.forename: Derek
authors.initials: D
authors.lastname: Brown
authors.affiliation: John P. Murtha Cancer Center, Walter Reed National Military Medical Center, Bethesda, MD, United States; Uniformed Services University, Bethesda, MD, United States.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Shao
authors.affiliation: The University of Texas Health Science Center at San Antonio, San Antonio, TX, United States.
authors.forename: Ismail
authors.initials: I
authors.lastname: Jatoi
authors.affiliation: John P. Murtha Cancer Center, Walter Reed National Military Medical Center, Bethesda, MD, United States; Uniformed Services University, Bethesda, MD, United States.
authors.forename: Craig D
authors.initials: CD
authors.lastname: Shriver
authors.affiliation: John P. Murtha Cancer Center, Walter Reed National Military Medical Center, Bethesda, MD, United States; Uniformed Services University, Bethesda, MD, United States. Electronic address: kzhu@usuhs.mil.
authors.forename: Kangmin
authors.initials: K
authors.lastname: Zhu
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000208:ethnology*; D005006:Ethnicity; D005260:Female; D006801:Humans; D008875:Middle Aged; D011374:Progesterone / Q000378:metabolism*; D000072036:Prophylactic Mastectomy / Q000639:trends*; D011960:Receptors, Estrogen / Q000378:metabolism*; D011980:Receptors, Progesterone; D055815:Young Adult
chemical_list: D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D011374:Progesterone
keywords: Contralateral prophylactic mastectomy; Ethnicity; Hormone receptor; Race; SEER