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Patients who resided in zip codes with the lowest education levels were significantly more likely to receive no lymph node assessment compared to those from areas with the highest education levels (OR 1.13, p=0.0001). But the greatest disparities were observed by age group. Patients 62 to 72 years old were 1.1 times a likely to receive no axillary lymph assessment (p<0.01) compared to patients 50 and under, while the oldest patients (age 73 and older) were more than three times as likely (OR 3.30, p<0.0001) not to receive any assessment compared to those 50 and under.

These results indicate that significant disparities exist in receipt of axillary lymph node assessments among women with early stage breast cancer, said Dr. Halpern, American Cancer Society strategic director of health services research and study co-author. While treatment guidelines indicate that axillary lymph node assessment may be considered optional in certain patient groups, it remains a key component in determining stage, and thereby both prognosis and appropriate treatment options. Disparity in receipt of this procedure among underserved populations is therefore a concern and requires further study.

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