Uninsured, others less likely to receive breast c...( ATLANTAAn American Cancer Society st...),Health

ATLANTAAn American Cancer Society study finds breast cancer patients who lack insurance, who come from areas with lower education levels, who are African American, or who are older are less likely to get a key diagnostic test to make appropriate treatment decisions. The study finds those groups are ten percent to three times more likely not to receive tests to determine if the breast cancer has spread to axillary (underarm) lymph nodes. An abstract of the study was presented at the American Association for Cancer Research conference on the health disparities, held November 27-30 in Atlanta.

In axillary lymph node dissection, lymph nodes near the tumor are removed and looked at under the microscope. When the lymph nodes show signs of the tumor, there is an increased likelihood that cancer cells have spread through the bloodstream to other parts of the body. This information is an important part of staging and also helps to help guide breast cancer treatment decisions.

American Cancer Society researchers led by Michael Halpern, M.D., Ph.D., investigated factors associated with receipt of lymph node assessment among women with early stage breast cancer using data from the National Cancer Database (NCDB), a hospital-based registry jointly sponsored by the American Cancer Society and American College of Surgeons. Researchers reviewed records for 196,732 women diagnosed with early stage breast cancer from 2003 to 2005. The analysis found that eleven percent of patients overall did not receive any axillary lymph node assessment. Compared to White patients, African Americans were ten percent more likely to receive no axillary lymph node assessments (odds ratio [OR] 1.10, p<0.001). There were no significant differences for Hispanic or other non-White patients.

Women who were uninsured were 24 percent more likely to have no assessment compared to those with private insurance (OR 1.24, p<0.0005). A similar increase in the likelihood of no assess
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