OBJECTIVE: Previous studies have demonstrated substantial variations in breast conserving surgery (BCS) across sociodemographic groups. This study explored the joint influences of socioeconomic, immigration/acculturation, and clinical factors on ethnic differences in breast cancer surgery for early-stage disease. DESIGN: The study used interview data for 297 women, under the age of 70, who resided in the San Francisco Bay area, and had been diagnosed with primary early-stage breast cancer (carcinoma in-situ or invasive) between January 1990 and December 1992. RESULTS: The proportion of patients who either had undergone BCS or had no surgery was 45%, 20%, 45%, and 34%, among Whites, Chinese, Blacks, and Hispanics, respectively. The proportion of patients diagnosed at in-situ or localized stages, with tumors of less than 4 centimeters, was higher among those who received BCS or no surgery, compared to those who had undergone a mastectomy. White women who received BCS/no surgery tended to be younger than their counterparts who underwent mastectomies, but Chinese and Black women who received BCS/no surgery were older. The proportion of women diagnosed in smaller, private hospitals was higher among those receiving BCS/no surgery, although these associations varied by ethnicity. Women who had undergone BCS/no surgery were characterized as being of higher socioeconomic status, more acculturated, and less likely to be recent immigrants. In a multivariate regression model adjusting for clinical, socioeconomic, and immigration/acculturation factors, Chinese women were more likely than Whites to have a mastectomy, rather than BCS/no surgery (odds ratio, 2.8; 95% confidence interval, 1.0-7.8). CONCLUSIONS: Use of BCS or no surgery was associated with various clinical, socioeconomic, and immigration/acculturation characteristics, although some of the associations varied by ethnicity. However, these factors did not account for the reduced presence of BCS, or no surgery, among Chinese women.
OBJECTIVE: Previous studies have demonstrated substantial variations in breast conserving surgery (BCS) across sociodemographic groups. This study explored the joint influences of socioeconomic, immigration/acculturation, and clinical factors on ethnic differences in breast cancer surgery for early-stage disease. DESIGN: The study used interview data for 297 women, under the age of 70, who resided in the San Francisco Bay area, and had been diagnosed with primary early-stage breast cancer (carcinoma in-situ or invasive) between January 1990 and December 1992. RESULTS: The proportion of patients who either had undergone BCS or had no surgery was 45%, 20%, 45%, and 34%, among Whites, Chinese, Blacks, and Hispanics, respectively. The proportion of patients diagnosed at in-situ or localized stages, with tumors of less than 4 centimeters, was higher among those who received BCS or no surgery, compared to those who had undergone a mastectomy. White women who received BCS/no surgery tended to be younger than their counterparts who underwent mastectomies, but Chinese and Black women who received BCS/no surgery were older. The proportion of women diagnosed in smaller, private hospitals was higher among those receiving BCS/no surgery, although these associations varied by ethnicity. Women who had undergone BCS/no surgery were characterized as being of higher socioeconomic status, more acculturated, and less likely to be recent immigrants. In a multivariate regression model adjusting for clinical, socioeconomic, and immigration/acculturation factors, Chinese women were more likely than Whites to have a mastectomy, rather than BCS/no surgery (odds ratio, 2.8; 95% confidence interval, 1.0-7.8). CONCLUSIONS: Use of BCS or no surgery was associated with various clinical, socioeconomic, and immigration/acculturation characteristics, although some of the associations varied by ethnicity. However, these factors did not account for the reduced presence of BCS, or no surgery, among Chinese women.
Authors: Scarlett Lin Gomez; Christina A Clarke; Sarah J Shema; Ellen T Chang; Theresa H M Keegan; Sally L Glaser Journal: Am J Public Health Date: 2010-03-18 Impact factor: 9.308
Authors: Signe Smith Nielsen; Yulei He; John Z Ayanian; Scarlett Lin Gomez; Katherine L Kahn; Dee W West; Nancy L Keating Journal: Cancer Date: 2010-07-29 Impact factor: 6.860
Authors: Heather Spencer Feigelson; Ted A James; Richard M Single; Adedayo A Onitilo; Erin J Aiello Bowles; Tom Barney; Jordan E Bakerman; Laurence E McCahill Journal: J Am Coll Surg Date: 2013-03-13 Impact factor: 6.113
Authors: Dawn L Hershman; Lawrence H Kushi; Theresa Shao; Donna Buono; Aaron Kershenbaum; Wei-Yann Tsai; Louis Fehrenbacher; Scarlett Lin Gomez; Sunita Miles; Alfred I Neugut Journal: J Clin Oncol Date: 2010-06-28 Impact factor: 44.544
Authors: Laura A McClure; Sally L Glaser; Sarah J Shema; Laura Allen; Charles Quesenberry; Esther M John; Scarlett L Gomez Journal: J Immigr Minor Health Date: 2010-08