Surgical treatment of young women with breast cancer: Public vs private hospitals

Ami Patel*, Wen Jie Wang, Elizabeth Warnack, Kathie Anne Joseph, Freya Schnabel, Deborah Axelrod, Shubhada Dhage

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Disparities in breast cancer treatment have been documented in young and underserved women. This study aimed to determine whether surgical disparities exist among young breast cancer patients by comparing cancer treatment at a public safety-net hospital (BH) and private cancer center (PCC) within a single institution. This was a retrospective study of young women (<45) diagnosed with invasive breast cancer (stage I-III) from 2011-2016. Patient information was abstracted from the breast cancer database at BH and PCC. Demographic variables, surgery type, method of presentation, and stage were analyzed using Pearson's chi-square tests and binary logistic regression. A total of 275 patients between ages 25-45 with invasive breast cancer (Stage I-III) were included in the study. There were 69 patients from BH and 206 patients from PCC. At PCC, the majority of patients were Caucasian (68%), followed by Asian (11%), Hispanic (10%), and African American (8.7%). At BH, patients were mostly Hispanic (47.8%), followed by Asian (27.5%), and African American (10.1%). At PCC, 82% had a college/graduate degree versus 18.6% of patients at BH (P < 0.001). All patients at PCC reported English as their primary language versus 30% of patients at BH (P < 0.001). Patients at PCC were more likely to present with lower stage cancer (P = 0.04), and less likely to present with a palpable mass (P = 0.04). Hospital type was not a predictor of receipt of mastectomy (P = 0.5), nor was race, primary language, or education level. Of patients who received a mastectomy, 87% at BH and 76% at PCC had immediate reconstruction. Surgical management of young women with breast cancer in a public hospital versus private hospital setting was equivalent, even after controlling for race, primary language, stage, and education level.

Original languageEnglish (US)
Pages (from-to)625-630
Number of pages6
JournalBreast Journal
Volume25
Issue number4
DOIs
StatePublished - Jul 1 2019
Externally publishedYes

Keywords

  • age disparity
  • breast cancer
  • health disparity

ASJC Scopus subject areas

  • Internal Medicine
  • Surgery
  • Oncology

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