ArticleCancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology2023
Patterns of Evidence-Based Care for the Diagnosis, Staging, and First-line Treatment of Breast Cancer by Race-Ethnicity: A SEER-Medicare Study.
Article in Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Self-reported racial and ethnic discrimination in patient-provider interactions and the initiation of adjuvant therapies for breast cancer in the pathways study.Breast cancer research and treatment · 2026Article
- Guideline-concordance along the cancer care continuum and breast cancer mortality by race and ethnicity: a SEER-Medicare study.Cancer causes & control : CCC · 2026Article
- Care coordination and communication for Native American patients with cancer.The oncologist · 2026Article
- Hidden in the Data: Breast Cancer Patterns, Gaps, and Challenges for Native American Women.Current breast cancer reports · 2026Review
- Real-world treatment patterns among patients diagnosed with hormone receptor-positive metastatic breast cancer in the USA.British journal of clinical pharmacology · 2025Observational
- Comorbidities among American Indian and Alaska Native People with Cancer: A Surveillance, Epidemiology, and End Results-Medicare Study.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2025Article
- Comparative real-world survival of first-line atezolizumab, nivolumab, and pembrolizumab in older patients with metastatic non-small cell lung cancer.Journal of managed care & specialty pharmacy · 2025Article
- Racial and Ethnic Disparities Along the Treatment Cascade Among Medicare Fee-for-Service Beneficiaries With Metastatic Breast, Colorectal, Lung, and Prostate Cancers.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2025Article
- Racial and Ethnic Disparities in Receipt of ERBB2-Targeted Therapy for Breast Cancer, 2010-2020.JAMA network open · 2025Article
- Prevalence of surgery in Indigenous people with cancer: a systematic review and meta-analysis.The Lancet regional health. Western Pacific · 2025Article
- Guideline-concordant breast cancer care by patient race and ethnicity accounting for individual-, facility- and area-level characteristics: a SEER-Medicare study.Cancer causes & control : CCC · 2024Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
backgroundRacial and ethnic disparities in guideline-recommended breast cancer treatment are well documented, however studies including diagnostic and staging procedures necessary to determine treatment indications are lacking. The purpose of this study was to characterize patterns in delivery of evidence-based services for the diagnosis, clinical workup, and first-line treatment of breast cancer by race-ethnicity.
methodsSEER-Medicare data were used to identify women diagnosed with invasive breast cancer between 2000 and 2017 at age 66 or older (n = 2,15,605). Evidence-based services included diagnostic procedures (diagnostic mammography and breast biopsy), clinical workup (stage and grade determination, lymph node biopsy, and HR and HER2 status determination), and treatment initiation (surgery, radiation, chemotherapy, hormone therapy, and HER2-targeted therapy). Poisson regression was used to estimate rate ratios (RR) and 95% confidence intervals (CI) for each service.
resultsBlack and American Indian/Alaska Native (AIAN) women had significantly lower rates of evidence-based care across the continuum from diagnostics through first-line treatment compared to non-Hispanic White (NHW) women. AIAN women had the lowest rates of HER2-targeted therapy and hormone therapy initiation. While Black women also had lower initiation of HER2-targeted therapy than NHW, differences in hormone therapy were not observed.
conclusionsOur findings suggest patterns along the continuum of care from diagnostic procedures to treatment initiation may differ across race-ethnicity groups. IMPACT: Efforts to improve delivery of guideline-concordant treatment and mitigate racial-ethnic disparities in healthcare and survival should include procedures performed as part of the diagnosis, clinical workup, and staging processes.
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