Ethnicity and the surgical management of early invasive breast cancer in over 164 000 women.
Adult
Age Distribution
Aged
Aged, 80 and over
Breast Neoplasms
/ pathology
Carcinoma in Situ
/ pathology
Carcinoma, Ductal, Breast
/ pathology
Early Detection of Cancer
England
/ epidemiology
Female
Humans
Mastectomy
/ statistics & numerical data
Middle Aged
Racial Groups
/ statistics & numerical data
Journal
The British journal of surgery
ISSN: 1365-2168
Titre abrégé: Br J Surg
Pays: England
ID NLM: 0372553
Informations de publication
Date de publication:
27 05 2021
27 05 2021
Historique:
received:
12
02
2020
revised:
10
04
2020
accepted:
07
06
2020
entrez:
27
5
2021
pubmed:
28
5
2021
medline:
5
10
2021
Statut:
ppublish
Résumé
Limited information is available about patterns of surgical management of early breast cancer by ethnicity of women in England, and any potential inequalities in the treatment received for breast cancer. National Cancer Registration and Analysis Service data for women diagnosed with early invasive breast cancer (ICD-10 C50) during 2012-2017 were analysed. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95 per cent confidence intervals for the risk of mastectomy versus breast-conserving surgery by ethnicity (black African, black Caribbean, Indian, Pakistani and white), adjusting for age, region, deprivation, year of diagnosis, co-morbidity and stage at diagnosis. Data from 164 143 women were included in the analysis. The proportion of women undergoing mastectomy fell by approximately 5 per cent between 2012 and 2017 across all the ethnic groups examined. In unadjusted analyses, each ethnic minority group had a significantly higher odds of mastectomy than white women; however, in the fully adjusted model, there were no significantly increased odds of having mastectomy for women of any ethnic minority group examined. For example, compared with white women, the unadjusted and fully adjusted ORs for mastectomy were 1·14 (95 per cent c.i. 1·05 to 1·20) and 1·04 (0·96 to 1·14) respectively for Indian women, and 1·45 (1·30 to 1·62) and 1·00 (0·89 to 1·13) for black African women. This attenuation in OR by ethnicity was largely due to adjustment for age and stage. Allowing for different patterns of age and stage at presentation, the surgical management of early breast cancer is similar in all women, regardless of ethnicity.
Sections du résumé
BACKGROUND
Limited information is available about patterns of surgical management of early breast cancer by ethnicity of women in England, and any potential inequalities in the treatment received for breast cancer.
METHODS
National Cancer Registration and Analysis Service data for women diagnosed with early invasive breast cancer (ICD-10 C50) during 2012-2017 were analysed. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95 per cent confidence intervals for the risk of mastectomy versus breast-conserving surgery by ethnicity (black African, black Caribbean, Indian, Pakistani and white), adjusting for age, region, deprivation, year of diagnosis, co-morbidity and stage at diagnosis.
RESULTS
Data from 164 143 women were included in the analysis. The proportion of women undergoing mastectomy fell by approximately 5 per cent between 2012 and 2017 across all the ethnic groups examined. In unadjusted analyses, each ethnic minority group had a significantly higher odds of mastectomy than white women; however, in the fully adjusted model, there were no significantly increased odds of having mastectomy for women of any ethnic minority group examined. For example, compared with white women, the unadjusted and fully adjusted ORs for mastectomy were 1·14 (95 per cent c.i. 1·05 to 1·20) and 1·04 (0·96 to 1·14) respectively for Indian women, and 1·45 (1·30 to 1·62) and 1·00 (0·89 to 1·13) for black African women. This attenuation in OR by ethnicity was largely due to adjustment for age and stage.
CONCLUSION
Allowing for different patterns of age and stage at presentation, the surgical management of early breast cancer is similar in all women, regardless of ethnicity.
Identifiants
pubmed: 34043777
pii: 6287139
doi: 10.1002/bjs.11865
pmc: PMC8210682
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
528-533Subventions
Organisme : Cancer Research UK
Pays : United Kingdom
Informations de copyright
© The Author(s) 2021. Published by Oxford University Press on behalf of BJS Society Ltd.
Références
N Engl J Med. 2002 Oct 17;347(16):1233-41
pubmed: 12393820
Eur J Cancer Care (Engl). 2017 Jan;26(1):
pubmed: 27515153
Br J Cancer. 2014 Jan 7;110(1):224-9
pubmed: 24169349
Br J Cancer. 2004 May 17;90(10):1926-32
pubmed: 15138473
Eur Heart J. 2009 Sep;30(17):2137-46
pubmed: 19520708
BMJ Open. 2015 Mar 13;5(3):e006944
pubmed: 25770231
BMC Public Health. 2012 Mar 27;12:243
pubmed: 22452827
Br J Cancer. 2015 Dec 1;113(11):1640
pubmed: 26625218
Br J Cancer. 2015 Jun 30;113(1):173-81
pubmed: 26079299
Br J Surg. 2016 Aug;103(9):1147-56
pubmed: 27324317
J Public Health (Oxf). 2014 Dec;36(4):684-92
pubmed: 24323951
Br J Cancer. 2016 Nov 22;115(11):1408-1415
pubmed: 27780193
Br J Cancer. 2016 Mar 1;114(5):597-604
pubmed: 26867159
Br J Cancer. 2003 Aug 4;89(3):508-12
pubmed: 12888822
J Med Screen. 2011;18(2):96-102
pubmed: 21852703
N Engl J Med. 2002 Oct 17;347(16):1227-32
pubmed: 12393819
BMJ. 2009 Jun 16;338:b2025
pubmed: 19531549
Br J Cancer. 2009 Feb 10;100(3):545-50
pubmed: 19127253
J Clin Epidemiol. 1994 Nov;47(11):1245-51
pubmed: 7722560