Patterns of Care and Disparities in the Treatment of Early Breast Cancer
Abstract
Prior research evidence that has suggested that regional variation and socioeconomic barriers in breast cancer treatment remain substantial problems for patients across the nation. The purpose of our project was to characterize national patterns in the treatment of early invasive breast cancer in older women with incident disease. We specifically sought to characterize disparities in care and regional variation in treatment patterns. Methods. We sought to apply a novel resource, comprehensive national Medicare claims data, to study disparities in care and outcomes in women with breast cancer. We calculated national and state-by-state absolute and standardized utilization rates of radiotherapy (RT) and chemotherapy in patients with early invasive breast cancer treated with conservative surgery (CS); analyzed the modifying effect of race on RT utilization; and evaluated the utility of claims-based covariates in predicting breast cancer stage. Multivariate logistic regression was used to model these outcomes. Findings. Significant regional variation in utilization of breast cancer treatment existed in our cohort of older women diagnosed with invasive disease, even after standardization for patient and disease characteristics. In addition, significant racial disparities in care existed, with non-white women significantly less likely than white women to receive RT after CS, despite this treatment modality generally considered standard treatment. Conclusions. Our research adds to the existing literature by providing the first comprehensive national sample to address these study questions. Our future research will extend on our current findings by determining whether these variations in breast cancer treatment also affect outcomes, such as cancer recurrence, mortality, and costs of cancer care.
Document Details
- Document Type
- Technical Report
- Publication Date
- Sep 30, 2008
- Accession Number
- ADA493994
Entities
People
- Grace L Smith
Organizations
- The University of Texas MD Anderson Cancer Center