Early Stage Breast Cancer Treatments for Younger Medicare Beneficiaries with Different Disabilities

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Abstract
Objective. To explore how underlying disability affects treatments and outcomes of disabled women with breast cancer. Data Sources. Surveillance, Epidemiology, and End Results program data, linked with Medicare files and Social Security Administration disability group. Study Design. Ninety thousand two hundred and forty-three incident cases of early-stage breast cancer under age 65; adjusted relative risks and hazards ratios examined treatments and survival, respectively, for women in four disability groups compared with nondisabled women. Principal Findings. Demographic characteristics, treatments, and survival varied among four disability groups. Compared with nondisabled women, those with mental disorders and neurological conditions had significantly lower adjusted rates of breast conserving surgery and radiation therapy. Survival outcomes also varied by disability type. Conclusions. Compared with nondisabled women, certain subgroups of women with disabilities are especially likely to experience disparities in care for breast cancer.