BACKGROUND: Health care disparities have been identified in the treatment of older and racial/ethnic minority breast carcinoma patients. The purpose of the current study was to examine racial/ethnic group differences in the treatment decision-making process of older breast carcinoma patients and the differential impact on treatment received. METHODS: A cross-sectional survey was conducted of a population-based, consecutive sample identified by the Los Angeles Cancer Surveillance Program comprised of Latina (n = 99), African-American (n = 66), and white (n = 92) women age > or = 55 years (total n = 257) and who were between 3-9 months after their primary breast carcinoma diagnosis. RESULTS: Approximately 49% of less acculturated Latinas and 18% of more acculturated Latinas indicated that their family members determined the final treatment decision, compared with less than 4% of African-Americans and whites (P < 0.001). This disparity remained in multiple logistic regression analysis, controlling for potential confounders, including sociodemographic, physician-patient communication, social support, and health variables. Compared with African-American and white women, Latina women were more likely to identify a family member as the final treatment decision-maker (adjusted odds ratio [AOR] of 7.97; 95% confidence interval [95% CI], 2.43-26.20, for less acculturated Latinas; and AOR of 4.48; 95% CI, 1.09-18.45, for more acculturated Latinas). A multiple logistic regression model, controlling for sociodemographic and health characteristics, indicated that patients were less likely to receive breast-conserving surgery (BCS) when the family made the final treatment decision (AOR of 0.39; 95% CI, 0.18-0.85). CONCLUSIONS: Family appears to play a powerful role in treatment decision-making among older Latina breast carcinoma patients, regardless of the level of acculturation. This family influence appears to contribute to racial/ethnic group differences in treatment received. Physicians should acknowledge and educate patients' family members as potential key participants in medical decision-making, rather than merely as translators and providers of social support. Copyright 2006 American Cancer Society.
BACKGROUND: Health care disparities have been identified in the treatment of older and racial/ethnic minority breast carcinomapatients. The purpose of the current study was to examine racial/ethnic group differences in the treatment decision-making process of older breast carcinomapatients and the differential impact on treatment received. METHODS: A cross-sectional survey was conducted of a population-based, consecutive sample identified by the Los Angeles Cancer Surveillance Program comprised of Latina (n = 99), African-American (n = 66), and white (n = 92) women age > or = 55 years (total n = 257) and who were between 3-9 months after their primary breast carcinoma diagnosis. RESULTS: Approximately 49% of less acculturated Latinas and 18% of more acculturated Latinas indicated that their family members determined the final treatment decision, compared with less than 4% of African-Americans and whites (P < 0.001). This disparity remained in multiple logistic regression analysis, controlling for potential confounders, including sociodemographic, physician-patient communication, social support, and health variables. Compared with African-American and white women, Latina women were more likely to identify a family member as the final treatment decision-maker (adjusted odds ratio [AOR] of 7.97; 95% confidence interval [95% CI], 2.43-26.20, for less acculturated Latinas; and AOR of 4.48; 95% CI, 1.09-18.45, for more acculturated Latinas). A multiple logistic regression model, controlling for sociodemographic and health characteristics, indicated that patients were less likely to receive breast-conserving surgery (BCS) when the family made the final treatment decision (AOR of 0.39; 95% CI, 0.18-0.85). CONCLUSIONS: Family appears to play a powerful role in treatment decision-making among older Latina breast carcinomapatients, regardless of the level of acculturation. This family influence appears to contribute to racial/ethnic group differences in treatment received. Physicians should acknowledge and educate patients' family members as potential key participants in medical decision-making, rather than merely as translators and providers of social support. Copyright 2006 American Cancer Society.
Authors: Tracy A Battaglia; Julie S Darnell; Naomi Ko; Fred Snyder; Electra D Paskett; Kristen J Wells; Elizabeth M Whitley; Jennifer J Griggs; Anand Karnad; Heather Young; Victoria Warren-Mears; Melissa A Simon; Elizabeth Calhoun Journal: Breast Cancer Res Treat Date: 2016-07-18 Impact factor: 4.872
Authors: Mónica E López; Celia P Kaplan; Anna M Nápoles; E Shelley Hwang; Jennifer C Livaudais; Leah S Karliner Journal: Patient Educ Couns Date: 2013-09-17
Authors: S Yousuf Zafar; Stewart C Alexander; Kevin P Weinfurt; Kevin A Schulman; Amy P Abernethy Journal: Support Care Cancer Date: 2008-09-19 Impact factor: 3.603
Authors: Karen M Freund; Tracy A Battaglia; Elizabeth Calhoun; Donald J Dudley; Kevin Fiscella; Electra Paskett; Peter C Raich; Richard G Roetzheim Journal: Cancer Date: 2008-12-15 Impact factor: 6.860