Racial and Ethnic Disparities in the Use of Postmastectomy Breast Reconstruction: Results From a Population- Based Study
Year: 2009
Type: article
Study design: Observational Study
Abstract: PURPOSE: There is concern that minority women have limited access to breast reconstruction. We described patterns of use, experiences with clinicians, and patients' satisfaction with treatment decisions for women of different race/ethnicities. METHODS: A total of 3,252 patients with breast cancer from Los Angeles and Detroit Surveillance, Epidemiology, and End Results registries were surveyed near the time of diagnosis (n = 2,260, response rate 72.2%). The primary outcomes were receipt of reconstruction, access to information about reconstruction, and decisional satisfaction. The primary independent variable was race/ethnicity (white, African American [AA], highly acculturated Latina [Latina-high], and less acculturated Latina [Latina-low]). Control variables included other sociodemographic and clinical factors. chi(2) and multivariate logistic regression were used for the analyses. RESULTS: Receipt of reconstruction varied significantly by patient race/ethnicity-40.9% of whites, 33.5% of AAs, 41.2% of Latina-high, and only 13.5% of Latina-low (P < .001)-and persisted when we controlled for demographic and clinical factors. Minority women were significantly less likely than whites to see a plastic surgeon before initial surgery and were more likely to desire more information about reconstruction (17.0% of whites v 27.0% of AAs, 30.0% of Latina-high, and 55.9% of Latina-low; P < .001). Decisional satisfaction was lowest among minority women without reconstruction (P < .001). CONCLUSION: Minority women, particularly less acculturated Latinas, had low receipt of breast reconstruction, which may be related to limited information about the procedure and less access to plastic surgeons. Greater desire for information and lower satisfaction with surgical decisions among these patients motivate greater attention to treatment support for these patients.
Source: Journal of Clinical Oncology
Institutions: Wayne State University, University of Michigan, The Barbara Ann Karmanos Cancer Institute, VA Ann Arbor Healthcare System, Michigan Medicine, Ann Arbor VA Medical Center, University of Southern California, Memorial Sloan Kettering Cancer Center, Harvard University, A. Alfred Taubman Health Care Center
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: G2309339098, #14: Residual Tissue Repository to Create HIV Cancer Tumor Tissue Microrarrays , G3193254293, G392292919, G5161562788, SEER RRSS #4: Cancer in Arab American Estimating Rates and Fostering Research, Racial/Ethnic Disparities In Work and Qol Outcomes In Survivors of Breast Cancer, G7278087418, G7507271246, Rapid Response Surveillance Study #09-5 - Constructing Geographic Areas in GIS fo, G87246893
OpenAlex ID: W2128404090