Feinberg
Northwestern Medicine | Northwestern University | Faculty Profiles

News Center

  • Categories
    • Campus News
    • Disease Discoveries
    • Clinical Breakthroughs
    • Education News
    • Scientific Advances
  • Press Releases
  • Media Coverage
  • Podcasts
  • Editor’s Picks
    • COVID-19
    • Cardiology
    • Cancer
    • Neurology and Neuroscience
    • Aging and Longevity
    • Artificial Intelligence in Medicine
  • News Archives
  • About Us
    • Media Contact
    • Share Your News
    • News Feeds
    • Social Media
    • Contact Us
Menu
  • Categories
    • Campus News
    • Disease Discoveries
    • Clinical Breakthroughs
    • Education News
    • Scientific Advances
  • Press Releases
  • Media Coverage
  • Podcasts
  • Editor’s Picks
    • COVID-19
    • Cardiology
    • Cancer
    • Neurology and Neuroscience
    • Aging and Longevity
    • Artificial Intelligence in Medicine
  • News Archives
  • About Us
    • Media Contact
    • Share Your News
    • News Feeds
    • Social Media
    • Contact Us
Home » Breast-Saving Surgery Underused by Some
Uncategorized

Breast-Saving Surgery Underused by Some

By medwebAug 1, 2005
Share
Facebook Twitter Email

Breast-Saving Surgery Underused by Some

CHICAGO—Asian American and Pacific Island women, particularly those born abroad, are less likely to receive breast-conserving surgery for early-stage breast cancer than non-Hispanic white women, according to a study published in the online Journal of General Internal Medicine.

“Differences in use of breast-saving surgery among foreign-born Asian American and Pacific Island women and non-Hispanic white women have persisted, despite the fact that in 1990 the National Cancer Institute (NCI) recommended breast-conserving surgery as first-line treatment for early-stage breast cancer,” said Mita Sanghavi Goel, MD, instructor in medicine at Northwestern University’s Feinberg School of Medicine, who led the study.

Breast cancer incidence and death appear to be rising among Asian American and Pacific Island women, the fastest growing minority group in the United States, underscoring the importance of studying patterns of breast cancer care in this population, Dr. Goel said.

Asian Americans and Pacific Islanders are disproportionately foreign-born compared to non-Hispanic white Americans. Moreover, foreign-born individuals are at risk for receiving poorer quality of care due to lower use of preventive services, lack of a regular source of health care, lower rates of insurance coverage, and cultural factors such as low English proficiency and lack of acculturation, Dr. Goel said.

Previous studies have found that Asian Americans and Pacific Islanders who are foreign born are less likely to receive cancer screening and hospice care than Asian Americans and Pacific Islanders who were born in the United States.

Dr. Goel and colleagues from Harvard Medical School and the University of California at Irvine College of Medicine believe that foreign birthplace may explain previously described disparities in breast-conserving surgery use between white and Asian American and Pacific Island women as well as among various Asian American and Pacific Island ethnic groups.

Using data from the NCI’s 1992–2000 Surveillance, Epidemiology, and End Results (SEER) Program, Dr. Goel and co-researchers analyzed demographic and tumor characteristics of more than 66,000 women diagnosed with early-stage, biopsy-proved breast cancer, 10,360 of whom were Asian American or Pacific Islander. Approximately 30 percent of the latter group were foreign-born; about 40 percent were U.S.-born; and 27 percent had an unknown birthplace.

Foreign-born Asian American and Pacific Islander women were more often diagnosed with Stage II (later stage) breast cancer, with lymph node involvement, larger tumors, and poorly differentiated or undifferentiated tumors than either non-Hispanic white or U.S.-born Asian American and Pacific Island women.

Overall, foreign-born Asian American and Pacific Island women were significantly less likely to receive breast-conserving surgery than non-Hispanic white women (43 percent and 56 percent, respectively, versus 59 percent).

For most demographic and tumor characteristics, Asian American and Pacific Island women, particularly those who were foreign-born, were less likely to receive breast-conserving surgery than non-Hispanic white women. Notably, foreign-born Asian American or Pacific Island women had substantially lower use of breast-conserving surgery even when diagnosed in the earliest stage or with tumors less than 1 centimeter in size.

The researchers also found that while use of breast-conserving surgery increased over time, foreign-born Asian American and Pacific Island women had breast-conserving surgery substantially less often than white and U.S.-born Asian American and Pacific Island women in any given year. Korean, Hawaiian, Indian, and Pakistani women were less likely to receive breast-conserving surgery than white women.

“Clinical factors, such as a history of connective tissue disease or undesirable cosmetic result, alone are unlikely to explain the observed differences,” Dr. Goel said.

In contrast, language barriers may contribute to observed differences in use of breast-saving surgery. Foreign-born Asian American and Pacific Islanders generally have lower English proficiency and thereby may have greater difficulty communicating with their physicians, possibly adversely affecting treatment outcomes.

Another explanation for the differences is that foreign-born Asian American women may be less likely to choose breast-conserving surgery. Despite conflicting evidence of the impact of mastectomy on the self-image of Asian American or Pacific Island women, some, especially immigrants, may prefer immediate treatment (mastectomy, which does not require additional radiation therapy).

Thus, the choice of mastectomy may be less disruptive to the care-taking roles many women hold in their families and may explain why Asian American and Pacific Island ethnic groups that are largely foreign-born, or generally less acculturated, may choose mastectomy.

Foreign-born individuals are less likely to have insurance; however, it was unclear whether insurance would account for the observed treatment disparities because the researchers focused only on women receiving some form of cancer treatment. More research on the insurance issue is required, Dr. Goel said.

This research was supported by an institutional National Research Service Award (5T32PE11001-15), the Ryoichi Sasakawa Fund, NCI award R29 CA79052, NIH grant K24 At00589-01A1, and NCI grant U01 CA 86322.

(Reprinted from the Northwestern University NewsCenter.)

Share. Facebook Twitter Email

Related Posts

Mar 29, 2023

Adolescent Sexual Health Program Receives Funding for Social Marketing Campaign

Mar 29, 2023

Lurie Cancer Center Receives Merit Extension from NCI

Oct 20, 2021

Drug Combination May Reduce Risk of Leukemia Relapse

Mar 26, 2020

Comments are closed.

Latest News

Coaxing Hair Growth in Aging Hair Follicle Stem Cells

Jun 9, 2023

New Therapeutic Target for Osteoarthritis Identified 

Jun 9, 2023

Largest Cell Map of Human Lung Reveals Insights Into Disease

Jun 8, 2023

McNally Honored with Walder Award

Jun 8, 2023

Biological Aging Increases Risk of Depression, Anxiety in Adults 

Jun 7, 2023
  • News Center Home
  • Categories
  • Press Release
  • Media Coverage
  • Editor’s Picks
  • News Archives
  • About Us
Flickr Photos
ANB05555
ANB08990
ANB09022
ANB09063
ANB09008
ANB08781
ANB08971
ANB09000
ANB08992
ANB09015
ANB09058
ANB09048

Northwestern University logo

Northwestern University Feinberg School of Medicine

RSS Facebook Twitter LinkedIn Flickr YouTube Instagram
Copyright © 2023 Northwestern University
  • Contact Northwestern University
  • Disclaimer
  • Campus Emergency Information
  • Policy Statements

Type above and press Enter to search. Press Esc to cancel.