Factors Associated with Surgery Among South Asian American and Non-Hispanic White Women with Breast Cancer.
Factors Associated with Surgery Among South Asian American and Non-Hispanic White Women with Breast Cancer.
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DOI：
10.33697/ajur.2021.048
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发表时间：
2021-12
期刊：
影响因子：
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通讯作者：
Satagopan JM
中科院分区：
文献类型：
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作者：
Lo L;Satagopan JM
南亚裔美国 (SA) 女性被诊断出的乳腺癌比非西班牙裔白人 (NHW) 女性更具侵袭性。了解与这些女性接受的手术类型相关的因素有助于了解这些文化不同人群的疾病管理。我们使用了监测、流行病学和最终结果 (SEER) 计划中 4,590 例 SA 和 429,030 例 NHW 乳腺癌病例的诊断年龄、分期、分级、雌激素和孕激素受体以及手术数据。我们使用逻辑回归以手术作为二元结果（皮下、全乳房切除术或根治性乳房切除术（STRM）与部分乳房切除术，无、未知或其他（PNUM）），并包括所有变量的累加效应以及年龄、阶段、等级以及雌激素和孕激素受体与种族/民族的相互作用。 5% 的 I 类误差用于评估效果的统计显着性。在 50 岁或之后诊断且患有局部疾病的女性中，相对于 PNUM 手术，SA 患者接受 STRM 的可能性明显高于 NHW 患者（比值比 (OR) = 1.27，95% 置信区间 (CI) = 1.06 – 1.52）。此外，在 50 岁之前诊断且患有局部或远处疾病的患者中，相对于 PNUM 手术，SA 病例接受 STRM 的可能性显着低于 NHW 病例（对于诊断年龄 < 40 岁，OR = 0.75，95% CI = 0.59 – 0.95；对于诊断年龄 40-49 岁，OR = 0.77，95% CI = 0.62 – 0.95）。 SA 和 NHW 女性接受的手术类型根据诊断年龄和疾病阶段而有所不同。南亚人 (SA) 是美国快速增长的少数民族人口，面临着包括乳腺癌在内的多种慢性疾病。与非西班牙裔白人 (NHW) 女性相比，南澳女性被诊断患有更具侵袭性的乳腺癌，其特点是诊断时年龄较小、处于局部或远处、级别较高且肿瘤呈 ER 阴性。手术——尤其是肿瘤切除术或乳房切除术——是乳腺癌的治疗方法之一。在美国，肿瘤切除术用于治疗早期乳腺癌，而乳房切除术用于治疗晚期乳腺癌。相比之下，无论疾病阶段如何，乳房切除术在亚洲国家更常用。相对于 NHW 病例，了解美国 SA 乳腺癌病例的手术类型以及有助于确定手术类型的因素非常重要。我们的分析揭示了 SA 和 NHW 乳腺癌病例接受的手术类型的差异，并且这些差异根据诊断年龄和疾病阶段而变化。需要进一步的研究来更深入地了解这些差异。
South Asian American (SA) women are diagnosed with more aggressive breast cancer than non-Hispanic White (NHW) women. Understanding the factors associated with the types of surgery received by these women sheds light on disease management in these culturally distinct populations. We used data on age at diagnosis, stage, grade, estrogen and progesterone receptors, and surgery from 4,590 SA and 429,030 NHW breast cancer cases in the Surveillance, Epidemiology and End Results (SEER) program. We used logistic regression with surgery as the binary outcome (subcutaneous, total, or radical mastectomy (STRM) versus partial mastectomy, no, unknown or other (PNUM)) and included additive effects of all the variables and interactions of age, stage, grade, and estrogen and progesterone receptors with race/ethnicity. Type I error of 5% was used to assess statistical significance of the effects. SA were significantly more likely than NHW cases to receive STRM relative to PNUM surgery among women diagnosed at or after age 50 years and having localized stage disease (Odds Ratio (OR) = 1.27, 95% Confidence Interval (CI) = 1.06 – 1.52). Further, SA were significantly less likely than NHW cases to receive STRM relative to PNUM surgery among those diagnosed before age 50 years and having regional or distant stage disease (OR = 0.75, 95% CI = 0.59 – 0.95 for age at diagnosis < 40 years; OR = 0.77, 95% CI = 0.62 – 0.95 for age at diagnosis 40–49 years). The type of surgery received by SA and NHW women differ according to age at diagnosis and disease stage. South Asians (SA) are a fast-growing minority population in the U.S and confront a wide range of chronic disease, including breast cancer. SA women are diagnosed with more aggressive breast cancer than non-Hispanic White (NHW) women, characterized by younger age at diagnosis, regional or distant stage, higher grade, and ER negative tumors. Surgery – especially lumpectomy or mastectomy – is one of the treatments available for breast cancer. In the U.S, lumpectomy is used to treat early-stage breast cancers, while mastectomy is used for later stage breast cancers. In contrast, mastectomy is more commonly used in Asian countries, regardless of disease stage. It is important to understand the type of surgery and the factors that contribute to determining the type of surgery in SA breast cancer cases in the U.S relative to NHW cases. Our analyses reveal differences in the type of surgery received by SA and NHW breast cancer cases, and these differences vary according to age at diagnosis and disease stage. Further research is needed to gain deeper insights into these differences.