Variations in time to receiving first surgical treatment for breast cancer as a function of racial/ethnic background: a cohort study

Abstract

OBJECTIVE To evaluate surgical treatment delay disparities by race/ethnic group in a group of breast cancer patients treated in the New York region. DESIGN Cohort study. SETTING Two affiliated hospitals in the New York region. PARTICIPANTS Patients admitted at two affiliated hospitals in the New York region for breast cancer treatment during 2007-2011. MAIN OUTCOME MEASURE Time to receiving first surgery for breast cancer, defined as the time in days between initial diagnosis (biopsy) and definitive surgical treatment (lumpectomy or mastectomy). Predicted time to first surgery by race group was also analysed using a multivariate linear regression model with adjustments made for several demographic and clinical factors. RESULTS Totally, 3071 patients who were first treated with surgery were identified. Racial background was classified as White, African American or Asian/other. Overall median time to surgery was 28 days: 28 days in whites, and 34 and 29 days in African Americans and Asian/others, respectively (p = 0.032). Multivariate analyses showed that only African Americans, not Asian/others, had significantly increased surgical delay compared to whites (p = 0.019). CONCLUSIONS This study demonstrates significant racial differences in surgical delay in a group of breast cancer patients treated in the New York region. These differences may reflect tacit attitudes of medical providers or processes insensitive to patient educational needs. Additional studies may improve our understanding of this delay.