Evidence map›Paper›PMID 26240131›Full record

ArticleThe oncologist2015

Breast Cancer Disparities: A Multicenter Comparison of Tumor Diagnosis, Characteristics, and Surgical Treatment in China and the U.S.

Priya G Sivasubramaniam, Bai-Lin Zhang, Qian Zhang, Jennifer S Smith, Bin Zhang, Zhong-Hua Tang, Guo-Ji Chen, Xiao-Ming Xie, Xiao-Zhou Xu, Hong-Jian Yang and 5 more

Open access · bronzeAbstract readMulticenter Study
In one paragraph

Article in The oncologist, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 1 pooled it
1.3field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 10 institutions in 2 countries.

Priya G SivasubramaniamFogarty Global Health Fellowship Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; Departments of Epidemiology and Breast Cancer, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union of Medical College, Beijing, People's Republic of China; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA; Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang, People's Republic of China; Department of Breast-Thyroid Surgery, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China; Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Gungzhou, People's Republic of China; Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Oncosurgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China; Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China; Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China.
Bai-Lin ZhangFogarty Global Health Fellowship Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; Departments of Epidemiology and Breast Cancer, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union of Medical College, Beijing, People's Republic of China; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA; Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang, People's Republic of China; Department of Breast-Thyroid Surgery, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China; Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Gungzhou, People's Republic of China; Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Oncosurgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China; Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China; Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China.
Qian ZhangFogarty Global Health Fellowship Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; Departments of Epidemiology and Breast Cancer, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union of Medical College, Beijing, People's Republic of China; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA; Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang, People's Republic of China; Department of Breast-Thyroid Surgery, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China; Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Gungzhou, People's Republic of China; Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Oncosurgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China; Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China; Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China.
Jennifer S SmithFogarty Global Health Fellowship Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; Departments of Epidemiology and Breast Cancer, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union of Medical College, Beijing, People's Republic of China; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA; Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang, People's Republic of China; Department of Breast-Thyroid Surgery, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China; Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Gungzhou, People's Republic of China; Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Oncosurgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China; Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China; Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China.
Bin ZhangFogarty Global Health Fellowship Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; Departments of Epidemiology and Breast Cancer, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union of Medical College, Beijing, People's Republic of China; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA; Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang, People's Republic of China; Department of Breast-Thyroid Surgery, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China; Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Gungzhou, People's Republic of China; Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Oncosurgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China; Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China; Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China.
Zhong-Hua TangFogarty Global Health Fellowship Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; Departments of Epidemiology and Breast Cancer, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union of Medical College, Beijing, People's Republic of China; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA; Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang, People's Republic of China; Department of Breast-Thyroid Surgery, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China; Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Gungzhou, People's Republic of China; Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Oncosurgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China; Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China; Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China.
Guo-Ji ChenFogarty Global Health Fellowship Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; Departments of Epidemiology and Breast Cancer, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union of Medical College, Beijing, People's Republic of China; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA; Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang, People's Republic of China; Department of Breast-Thyroid Surgery, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China; Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Gungzhou, People's Republic of China; Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Oncosurgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China; Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China; Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China.
Xiao-Ming XieFogarty Global Health Fellowship Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; Departments of Epidemiology and Breast Cancer, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union of Medical College, Beijing, People's Republic of China; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA; Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang, People's Republic of China; Department of Breast-Thyroid Surgery, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China; Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Gungzhou, People's Republic of China; Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Oncosurgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China; Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China; Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China.
Xiao-Zhou XuFogarty Global Health Fellowship Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; Departments of Epidemiology and Breast Cancer, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union of Medical College, Beijing, People's Republic of China; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA; Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang, People's Republic of China; Department of Breast-Thyroid Surgery, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China; Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Gungzhou, People's Republic of China; Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Oncosurgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China; Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China; Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China.
Hong-Jian YangFogarty Global Health Fellowship Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; Departments of Epidemiology and Breast Cancer, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union of Medical College, Beijing, People's Republic of China; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA; Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang, People's Republic of China; Department of Breast-Thyroid Surgery, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China; Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Gungzhou, People's Republic of China; Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Oncosurgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China; Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China; Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China.
Jian-Jun HeFogarty Global Health Fellowship Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; Departments of Epidemiology and Breast Cancer, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union of Medical College, Beijing, People's Republic of China; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA; Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang, People's Republic of China; Department of Breast-Thyroid Surgery, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China; Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Gungzhou, People's Republic of China; Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Oncosurgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China; Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China; Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China.
Hui LiFogarty Global Health Fellowship Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; Departments of Epidemiology and Breast Cancer, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union of Medical College, Beijing, People's Republic of China; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA; Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang, People's Republic of China; Department of Breast-Thyroid Surgery, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China; Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Gungzhou, People's Republic of China; Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Oncosurgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China; Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China; Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China.
Jia-Yuan LiFogarty Global Health Fellowship Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; Departments of Epidemiology and Breast Cancer, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union of Medical College, Beijing, People's Republic of China; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA; Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang, People's Republic of China; Department of Breast-Thyroid Surgery, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China; Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Gungzhou, People's Republic of China; Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Oncosurgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China; Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China; Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China.
Jin-Hu FanFogarty Global Health Fellowship Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; Departments of Epidemiology and Breast Cancer, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union of Medical College, Beijing, People's Republic of China; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA; Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang, People's Republic of China; Department of Breast-Thyroid Surgery, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China; Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Gungzhou, People's Republic of China; Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Oncosurgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China; Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China; Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China.
You-Lin QiaoFogarty Global Health Fellowship Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; Departments of Epidemiology and Breast Cancer, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union of Medical College, Beijing, People's Republic of China; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA; Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang, People's Republic of China; Department of Breast-Thyroid Surgery, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China; Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Gungzhou, People's Republic of China; Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Oncosurgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China; Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China; Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China qiaoy@cicams.ac.cn.
Chinese Academy of Medical Sciences & Peking Union Medical College · CNCentral South University · CNFirst Affiliated Hospital of Xi'an Jiaotong University · CNFogarty International Center · USLiaoning Cancer Hospital & Institute · CNSichuan Cancer Hospital · CNSichuan University · CNSun Yat-sen University · CNUniversity of North Carolina at Chapel Hill · USZhejiang Cancer Hospital · CN

Funding

Fogarty Global Health Fellows Coordinating CenterR25TW009340 · FIC · UNIV OF NORTH CAROLINA CHAPEL HILL · PI CHI, BENJAMIN H. · 2012 to 2016
$6.9M
FIC NIH HHS 5R25TW009340-02FIC NIH HHS R25 TW009340
6 · The paper itself

Abstract

BACKGROUND AND

objectiveIncidence of and mortality rates for breast cancer continue to rise in the People's Republic of China. The purpose of this study was to analyze differences in characteristics of breast malignancies between China and the U.S.

methodsData from 384,262 breast cancer patients registered in the U.S. Surveillance, Epidemiology, and End Results (SEER) program from 2000 to 2010 were compared with 4,211 Chinese breast cancer patients registered in a Chinese database from 1999 to 2008. Outcomes included age, race, histology, tumor and node staging, laterality, surgical treatment method, and reconstruction. The Pearson chi-square and Fisher's exact tests were used to compare rates.

resultsInfiltrating ductal carcinoma was the most common type of malignancy in the U.S. and China. The mean number of positive lymph nodes was higher in China (2.59 vs. 1.31, p < .001). Stage at diagnosis was higher in China (stage IIA vs. I, p < .001). Mean size of tumor at diagnosis was higher in China (32.63 vs. 21.57 mm). Mean age at diagnosis was lower in China (48.28 vs. 61.29 years, p < .001). Moreover, 2.0% of U.S. women underwent radical mastectomy compared with 12.5% in China, and 0.02% in China underwent reconstructive surgery.

conclusionChinese women were diagnosed at younger ages with higher stage and larger tumors and underwent more aggressive surgical treatment. Prospective trials should be conducted to address screening, surgical, and tumor discrepancies between China and the U.S. IMPLICATIONS FOR PRACTICE: Breast cancer patients in China are diagnosed at later stages than those in America, which might contribute to different clinical management and lower 5-year survival rate. This phenomenon suggests that an earlier detection and treatment program should be widely implemented in China. By comparing the characteristics of Chinese and Chinese-American patients, we found significant differences in tumor size, lymph nodes metastasis, and age at diagnosis. These consequences indicated that patients with similar genetic backgrounds may have different prognoses due to the influence of environment and social economic determinates.

Indexed as

Breast NeoplasmsCarcinoma, Ductal, BreastChinaFemaleHealthcare DisparitiesHumansMiddle AgedRetrospective StudiesSEER ProgramUnited StatesBreast cancerChinaDisparities

Identifiers

PMID26240131
PMCPMC4571797
OpenAlexW2114381817

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