The effect of system-level access factors on receipt of reconstruction among Latina and white women with DCIS

Celia Patricia Kaplan, Leah S. Karliner, E. Shelley Hwang, Joan Bloom, Susan Stewart, Dana Nickleach, Jessica Quinn, Angela Thrasher, Anna Maria Nápoles

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Treatment decisions associated with ductal carcinoma in situ (DCIS), including the decision to undergo breast reconstruction, may be more problematic for Latinas due to access and language issues. To help understand the factors that influence patients' receipt of reconstruction following mastectomy for DCIS, we conducted a population-based study of English- and Spanish-speaking Latina and non-Latina white women from 35 California counties. The objectives of this study were to identify the role of ethnicity and language in the receipt of reconstruction, the relationship between system-level factors and the receipt of reconstruction, and women's reasons for not undergoing reconstruction. Women aged 18 and older, who self-identified as Latina or non-Latino white and were diagnosed with DCIS between 2002 and 2005 were selected from eight California Cancer Registry (CCR) regions encompassing 35 counties. Approximately 24 months after diagnosis, they were surveyed about their DCIS treatment decisions. Survey data were merged with CCR records to obtain tumor and treatment data. The survey was successfully completed by 745 women, 239 of whom had a mastectomy and represent the sample included in this study. Whites had a higher completion rate than Latinas (67 and 55%, respectively). Analysis included descriptive statistics and logistic regression modeling. Mean age was 54 years. A greater proportion of whites had reconstruction (72%) compared to English-speaking Latinas (69%) and Spanish-speaking Latinas (40%). Multivariate analysis showed that women who were aged 65 and older, unemployed, and had a lower ratio of plastic surgeons in their county were less likely to have reconstructive surgery after mastectomy. The most frequent reasons mentioned not to receive reconstruction included lack of importance and desire to avoid additional surgery. Although ethnic/language differences in treatment selection were observed, multivariable analysis suggests that these differences could be explained by differential employment levels and geographic availability of plastic surgeons.

Original languageEnglish (US)
Pages (from-to)909-917
Number of pages9
JournalBreast Cancer Research and Treatment
Volume129
Issue number3
DOIs
StatePublished - Oct 2011
Externally publishedYes

Fingerprint

Carcinoma, Intraductal, Noninfiltrating
Hispanic Americans
Mastectomy
Language
Registries
Reconstructive Surgical Procedures
Neoplasms
Mammaplasty
Therapeutics
Multivariate Analysis
Logistic Models
Population

Keywords

  • Ductal carcinoma in situ
  • Latinas
  • Reconstruction
  • Treatment decisions

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

The effect of system-level access factors on receipt of reconstruction among Latina and white women with DCIS. / Kaplan, Celia Patricia; Karliner, Leah S.; Hwang, E. Shelley; Bloom, Joan; Stewart, Susan; Nickleach, Dana; Quinn, Jessica; Thrasher, Angela; Nápoles, Anna Maria.

In: Breast Cancer Research and Treatment, Vol. 129, No. 3, 10.2011, p. 909-917.

Research output: Contribution to journalArticle

Kaplan, CP, Karliner, LS, Hwang, ES, Bloom, J, Stewart, S, Nickleach, D, Quinn, J, Thrasher, A & Nápoles, AM 2011, 'The effect of system-level access factors on receipt of reconstruction among Latina and white women with DCIS', Breast Cancer Research and Treatment, vol. 129, no. 3, pp. 909-917. https://doi.org/10.1007/s10549-011-1524-0
Kaplan, Celia Patricia ; Karliner, Leah S. ; Hwang, E. Shelley ; Bloom, Joan ; Stewart, Susan ; Nickleach, Dana ; Quinn, Jessica ; Thrasher, Angela ; Nápoles, Anna Maria. / The effect of system-level access factors on receipt of reconstruction among Latina and white women with DCIS. In: Breast Cancer Research and Treatment. 2011 ; Vol. 129, No. 3. pp. 909-917.
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