BACKGROUND: Late diagnosis of breast cancer is associated with lower survival. This study determines the factors associated with late-stage breast cancer diagnosis in an urban safety-net hospital (SNH) with excess late-stage disease. STUDY DESIGN: Single-institution retrospective study of all early-stage vs. late-stage breast cancer cases diagnosed or treated at the primary SNH in the Kansas City, Missouri area between January 2011-July 2018. Multiple logistic regression was performed to determine the variables that contributed most to late stage at diagnosis. RESULTS: The most significant factor associated with late-stage diagnosis was lack of screening mammogram within two years of diagnosis (p<.0001, OR 7.5, CI = 3.6, 15.3). Patients referred from within the SNH compared with those presenting from community health centers were significantly less likely to present with late-stage disease (p=.04, OR 0.50, CI = 0.25, 0.98). CONCLUSIONS: Screening mammography ought to be actively promoted in SNH settings with excess late-stage diagnosis.
BACKGROUND: Late diagnosis of breast cancer is associated with lower survival. This study determines the factors associated with late-stage breast cancer diagnosis in an urban safety-net hospital (SNH) with excess late-stage disease. STUDY DESIGN: Single-institution retrospective study of all early-stage vs. late-stage breast cancer cases diagnosed or treated at the primary SNH in the Kansas City, Missouri area between January 2011-July 2018. Multiple logistic regression was performed to determine the variables that contributed most to late stage at diagnosis. RESULTS: The most significant factor associated with late-stage diagnosis was lack of screening mammogram within two years of diagnosis (p<.0001, OR 7.5, CI = 3.6, 15.3). Patients referred from within the SNH compared with those presenting from community health centers were significantly less likely to present with late-stage disease (p=.04, OR 0.50, CI = 0.25, 0.98). CONCLUSIONS: Screening mammography ought to be actively promoted in SNH settings with excess late-stage diagnosis.
Authors: Asha D Nanda; Kayla R Reifel; Melissa P Mann; Miranda M Lyman-Hager; Kelly Overman; An-Lin Cheng; Jill Moormeier; Nasim Ahmadiyeh Journal: Ann Surg Oncol Date: 2022-08-17 Impact factor: 4.339