THURSDAY, April 25 (HealthDay News) -- A delay in breast cancer
treatment shortens young women's survival time, especially if they
are black or Hispanic, have no insurance or are low-income, a new
"A delay does influence the outcome, which is survival," said researcher Hoda Anton-Culver, chair of epidemiology at the University of California, Irvine.
A treatment delay time of more than six weeks affected survival
at the five-year mark, she found. Overall, 90 percent of women
treated less than two weeks after their diagnosis were alive five
years later, but that was the case for only 80 percent of those
whose treatment began more than six weeks after the diagnosis.
Hispanic and black women, compared to white women, were more
likely to have a treatment delay. So were low-income women; as well
as those with public or no insurance, compared to those with
In a separate study, researchers found that women on Medicaid,
the insurance plan for low-income patients, have larger breast
tumors at diagnosis compared to women who had private insurance.
Women on Medicaid were more likely to be treated with mastectomy
for large tumors compared to women with private insurance, the
study also found.
Both studies were published online April 24 in
Anton-Culver and her colleagues evaluated the records of nearly
9,000 teens and young adults, aged 15 to 39, with breast cancer,
who were in the California Cancer Registry database. They were
diagnosed from 1997 to 2006.
Hispanic and black women were almost twice as likely as white
women to have a treatment delay of more than six weeks. Low-income
women and those with public or no insurance were nearly twice as
likely to wait more than six weeks for treatment, compared to those
who were higher income or who had private insurance.
The 10-percent survival difference found in women who had a long
treatment delay is substantial, Anton-Culver said. "Losing 10
percent of women in that age group is a big loss," she said. Before
the cancer, their life expectancy was decades more.
Delays in treatment may have many reasons, she said. Minority
women and those who don't have as much access to health care may
simply have trouble getting to the doctor in a timely manner.
For their part, higher-income women may be juggling career and
family obligations and think the delay will not affect them,
Anton-Culver said. She tells them: "The cancer is not going to be
put on hold until you organize yourself."
"What we are saying in this paper is that you can't say, 'OK, I have breast cancer but I have to do a, b and c first, then I will pay attention to that.'"
In the second study, researchers from the University of Toledo
Medial Center, in Ohio, evaluated more than 1,500 women diagnosed
with stage 1 through stage 3 invasive breast cancer. All had
surgery between 1996 and 2009. Of those, 42 percent had a
mastectomy and 58 percent had breast-conserving surgery such as a
Overall, those on Medicaid were more likely to get a mastectomy
-- 60 percent compared with 39 percent.
Early detection efforts, including increasing the rate of
screening mammograms among those on Medicaid, could help more women
get breast-conserving surgery, the researchers said.
An expert who was not involved with the study agreed.
"Increasing screening programs for underinsured patients might help reduce this disparity in care," said Dr. Laura Kruper, director of the Cooper-Finkel Women's Health Center and co-director of the breast oncology program at the City of Hope Cancer Center, in Duarte, Calif.
The study has limitations, she said. "We don't know what the
delay is between feeling something [such as a lump] and getting a
diagnosis.'' Part of the delay may be postponing a doctor visit
because the women is in denial, doesn't have access to care or
other reasons, Kruper explained.
"Women who are lower socioeconomic status don't always have someone to watch their kids when they go in for an appointment," she said.
Fixing the disparities is not easy, Kruper said. Educating women
about the need for screening and for prompt treatment is complex.
"There is not one single approach that will work for all patients,"
she said. The solutions must take into account educational
differences, language barriers and cultural differences, among
other things, Kruper said.
To learn more about breast cancer, visit the
American Cancer Society.
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