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Breast cancer screening at the Breast Examination Center of Harlem
Aidan T Manning1, Anne Eaton, Michelle Azu
1Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Insights
Breast cancer screening at the Breast Examination Center of Harlem (BECH) increased early-stage diagnoses, yet Black and Hispanic women, often uninsured, still face poor outcomes and follow-up compliance issues.
Area of Science:
- Oncology
- Public Health
- Health Disparities
Background:
- Study describes patient, disease, and treatment characteristics of women diagnosed with breast cancer at the Breast Examination Center of Harlem (BECH).
- Investigates changes in these characteristics over time.
Purpose of the Study:
- To characterize breast cancer diagnoses at BECH from 2000-2008.
- To compare current trends with earlier data (1995-2000).
- To identify demographic and clinical factors influencing outcomes.
Main Methods:
- Retrospective chart review of 339 women diagnosed with breast cancer at BECH (2000-2008).
- Comparison with data from 1995-2000.
Main Results:
- Predominantly Black (55%) and Hispanic (39%) patients, with 52% uninsured.
- Increased diagnoses of preinvasive (29%) and stage I (36.5%) breast cancer compared to 1995-2000.
- Five-year overall survival was 83%; 79% for Black women.
- Nearly 40% followed for less than one year.
Conclusions:
- BECH serves predominantly uninsured Black and Hispanic women.
- Increasing early-stage diagnoses observed, but outcomes remain poor for these minorities.
- Challenges persist in follow-up compliance despite improved screening access.
Background:
This study was designed to describe patient, disease, and treatment characteristics of women diagnosed with breast cancer at the Breast Examination Center of Harlem (BECH) and to determine whether these characteristics have changed over time.
Methods:
Retrospective chart review of women diagnosed with breast cancer at BECH from 2000 to 2008 was performed. Comparisons were made to data from an earlier study period (1995-2000).
Results:
From 2000 to 2008, 339 women were diagnosed with breast cancer following attendance at BECH-55 % were black, 39 % Hispanic, 5 % of other race/ethnicity; 52 % had no health insurance. Hispanic patients were significantly more likely to have no health insurance compared with black patients (p = 0.0091); 29 % of patients had preinvasive disease and 36.5 % had stage I disease. Almost 40 % of the entire group was followed for <1 year. Five-year overall survival for the entire group was 83 % (95 % CI, 75-89 %) and 79 % for 188 Black women (95 % CI, 68-87 %). Compared with the earlier study period (1995-2000), fewer patients presented with palpable masses (45.4 vs. 67 %), and more had either stage 0 or stage I disease (65.6 vs. 46 %).
Conclusions:
Women diagnosed with breast cancer at BECH are predominantly Black and Hispanic, and most of these patients do not have health insurance. An increasing proportion of women diagnosed with breast cancer are presenting with nonpalpable, early-stage disease. Despite improved access to breast cancer screening, early stage at diagnosis, and access to appropriate management, these ethnic minorities continue to have poor outcomes and are poorly compliant with follow-up.