UCI study also reveals race, ethnicity and socioeconomic disparities
Irvine, Calif., April 24, 2013 — Young women with breast cancer who experience a longer surgical treatment delays have significantly decreased survival time compared with those with shorter delays – especially African-American and Latino women, those with public or no insurance, and those with low socioeconomic status, according to UC Irvine cancer epidemiologists.
Their findings appear online today in JAMA Surgery, a JAMA Network publication.
Breast cancer in women between the ages of 15 and 39 years (adolescents and young adults) accounts for about 5- to 6-percent of all breast cancer cases in the United States, and the disease is considered to be more aggressive and have a worse prognosis than in older woman, according to the study background.
Dr. Erlyn C. Smith, Dr. Argyrios Ziogas and Dr. Hoda Anton-Culver of UC Irvine conducted a retrospective case-only study of 8,860 breast cancer cases among adolescents and young adults diagnosed from 1997 to 2006 using the California Cancer Registry database. Treatment delay time was defined as the number of weeks between the date of diagnosis and date of definitive treatment.
“The data provided a unique perspective that can be used to improve the outcome of breast cancer in adolescents and young adult women. Our findings demonstrate that young women with a more-than six week delay in surgical treatment have shorter survival compared with those who had surgery closer to their diagnosis,” said Anton-Culver, professor and chair of epidemiology and director of the Genetic Epidemiology Research Institute at UC Irvine.
According to the results, treatment delays of more than six weeks after diagnosis were significantly different between racial and ethnic groups (Latino, 15.3 percent and African-American, 15.3 percent, compared with non-Hispanic white, 8.1 percent). Women with public or no insurance (17.8 percent) compared with those with private insurance (9.5 percent) and women with low socioeconomic status (17.5 percent) compared with those with high socioeconomic status (7.7 percent) were shown to experience treatment delay times of more than six weeks.
The five-year survival in women who were treated by surgery and had treatment delays of more than six weeks was 80 percent compared with 90 percent in those with treatment times of less than two weeks, the results also indicate.
“In conclusion, it is crucial to prevent further physician-related delays before and after the diagnosis of breast cancer is established to maximize the survival of these young women who are in the most productive time of their life,” Anton-Culver said.