Evidence map›Paper›PMID 39762708›Full record

ArticleBreast cancer research and treatment2025

Disparities in treatment delays among metastatic breast cancer patients: insights from nationwide electronic health records, 2011-2022.

Asal Pilehvari, Wen You, Gretchen Kimmick, Gloribel Bonilla, Roger Anderson

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Article in Breast cancer research and treatment, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
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

4 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
  4. Review
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

5 authors.

Asal PilehvariDepartment of Public Health Sciences, University of Virginia, 560 Ray C Hunt Dr., Room 2107, Charlottesville, VA, USA. Asal@virginia.edu.ORCID http://orcid.org/0000-0002-7793-7948
Wen YouDepartment of Public Health Sciences, University of Virginia, 560 Ray C Hunt Dr., Room 2107, Charlottesville, VA, USA.
Gretchen KimmickDuke University Medical Center, Durham, NC, USA.
Gloribel BonillaUniversity of Virginia Comprehensive Cancer Center, Charlottesville, VA, USA.
Roger AndersonDepartment of Public Health Sciences, University of Virginia, 560 Ray C Hunt Dr., Room 2107, Charlottesville, VA, USA.

Funding

American Cancer Society RWIA-21-123-01-RWIA
6 · The paper itself

Abstract

purposeWhile previous research has highlighted treatment delay inequities in early-stage breast cancer and identified potential contributing factors, there is limited research on disparities in treatment delays for metastatic breast cancer (MBC). This study investigates these disparities in MBC treatment initiation, aiming to identify key factors crucial for improving timely access to care.

methodNationwide Flatiron Health electronic health records-derived deidentified database, including females aged 18+ diagnosed with either De novo or relapsed MBC in the U.S. between 2011 and 2022. Treatment delay, defined as > 60 days between diagnosis and first-line treatment, was assessed as a binary variable. T-tests and chi-squared tests analyzed patient characteristics (age, race, insurance, diagnosis stage, metastasis site, phenotypes, etc.) among delayed and non-delayed groups. Logistic regression evaluated the association between clinical and non-clinical factors and treatment delays.

resultsAmong 20,617 patients with MBC, nearly 27% experienced treatment delays. These patients were generally younger, uninsured, historically marginalized, and newly diagnosed. Risk ratio analysis showed patients with only Medicare without secondary coverage (RR: 2.34, 95% CI [1.06, 5.16]) and uninsured (RR: 2.18, 95% CI [1.01, 4.76]) had higher risk of delays compared to those with commercial insurance. Historically marginalized patients had higher delay risk, ranging from 6% for Black patients to 12% for patients with not documented race/ethnicity background (p = 0.03) compared to White patients."

conclusionOur study highlights significant disparities in MBC treatment delays. Patients from historically marginalized groups and those without health insurance coverage or with only Medicare coverage are highly likely to experience delays. Addressing these disparities is essential for equitable healthcare and improved outcomes.

Indexed as

Breast NeoplasmsElectronic Health RecordsHealthcare DisparitiesTime-to-TreatmentAdultAgedAged, 80 and overFemaleHumansMiddle AgedNeoplasm MetastasisTreatment DelayUnited StatesYoung AdultHealth disparitiesInsurance coverageMarginalized populationsMetastatic breast cancerTreatment delays

Identifiers

PMID39762708

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.