Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Dec;160(3):563-572.
doi: 10.1007/s10549-016-4030-6. Epub 2016 Oct 22.

Comparing treatment and outcomes of ductal carcinoma in situ among women in Missouri by race

Chinwe C Madubata  1 , Ying Liu  2   3 , Melody S Goodman  1   4 , Shumei Yun  5 , Jennifer Yu  1 , Min Lian  4   6 , Graham A Colditz  1   4
Affiliations

Comparing treatment and outcomes of ductal carcinoma in situ among women in Missouri by race

Chinwe C Madubata et al. Breast Cancer Res Treat. 2016 Dec.

Abstract

Purpose: To investigate whether treatment (surgery, radiation therapy, and endocrine therapy) contributes to racial disparities in outcomes of ductal carcinoma in situ (DCIS).

Patients and methods: The analysis included 8184 non-Hispanic White and 954 non-Hispanic Black women diagnosed with DCIS between 1996 and 2011 and identified in the Missouri Cancer Registry. Logistic regression models were used to estimate odds ratios (ORs) of treatment for race. We used Cox proportional hazards regression models to estimate hazard ratios (HRs) of ipsilateral breast tumor (IBT) and contralateral breast tumor (CBT) for race.

Results: There was no significant difference between Black and White women in utilization of mastectomy (OR 1.16; 95 % CI 0.99-1.35) or endocrine therapy (OR 1.19; 95 % CI 0.94-1.51). Despite no significant difference in underutilization of radiation therapy (OR 1.14; 95 % CI 0.92-1.42), Black women had higher odds of radiation delay, defined as at least 8 weeks between surgery and radiation (OR 1.92; 95 % CI 1.55-2.37). Among 9138 patients, 184 had IBTs and 326 had CBTs. Black women had a higher risk of IBTs (HR 1.69; 95 % CI 1.15-2.50) and a comparable risk of CBTs (HR 1.19; 95 % CI 0.84-1.68), which were independent of pathological features and treatment.

Conclusion: Racial differences in DCIS treatment and outcomes exist in Missouri. This study could not completely explain the higher risk of IBTs in Black women. Future studies should identify differences in timely initiation and completion of treatment, which may contribute to the racial difference in IBTs after DCIS.

Keywords: Breast cancer; Cancer disparity; Ductal carcinoma in situ; Race; Second breast tumors.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest Disclosures: NONE.

Figures

Figure 1
Figure 1
Flow chart of cohort inclusion and exclusion criteria for women with primary ductal carcinoma in situ (DCIS) in the Missouri Cancer Registry
Figure 2
Figure 2
Cumulative incidences of ipsilateral second breast tumors (A) and contralateral breast tumors (B) among non-Hispanic White and non-Hispanic Black women with ductal carcinoma in situ
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Ernster VL, Ballard-Barbash R, Barlow WE, Zheng Y, Weaver DL, Cutter G, Yankaskas BC, Rosenberg R, Carney PA, Kerlikowske K, Taplin SH, Urban N, Geller BM. Detection of ductal carcinoma in situ in women undergoing screening mammography. J Natl Cancer Inst. 2002;94:1546–54. - PubMed
    1. Gradishar WJ, Anderson BO, Blair SL, Burstein HJ, Cyr A, Elias AD, Farrar WB, Forero A, Giordano SH, Goldstein LJ, Hayes DF, Hudis CA, Isakoff SJ, Ljung BM, Marcom PK, Mayer IA, McCormick B, Miller RS, Pegram M, Pierce LJ, Reed EC, Salerno KE, Schwartzberg LS, Smith ML, Soliman H, Somlo G, Ward JH, Wolff AC, Zellars R, Shead DA, Kumar R. Breast cancer version 3.2014. J Natl Compr Canc Netw. 2014;12:542–90. - PubMed
    1. Visvanathan K, Hurley P, Bantug E, Brown P, Col NF, Cuzick J, Davidson NE, Decensi A, Fabian C, Ford L, Garber J, Katapodi M, Kramer B, Morrow M, Parker B, Runowicz C, Vogel VG, 3rd, Wade JL, Lippman SM. Use of pharmacologic interventions for breast cancer risk reduction: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol. 2013;31:2942–62. - PubMed
    1. Ernster VL, Barclay J, Kerlikowske K, Wilkie H, Ballard-Barbash R. Mortality among women with ductal carcinoma in situ of the breast in the population-based surveillance, epidemiology and end results program. Arch Intern Med. 2000;160:953–8. - PubMed
    1. Solin LJ, Fourquet A, Vicini FA, Taylor M, Olivotto IA, Haffty B, Strom EA, Pierce LJ, Marks LB, Bartelink H, McNeese MD, Jhingran A, Wai E, Bijker N, Campana F, Hwang WT. Long-term outcome after breast-conservation treatment with radiation for mammographically detected ductal carcinoma in situ of the breast. Cancer. 2005;103:1137–46. - PubMed

MeSH terms

Substances

LinkOut - more resources