Differences in treatment patterns for localized breast carcinoma among Asian/Pacific islander women

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Abstract
BACKGROUND Many studies have examined racial/ethnic differences in treatment for localized breast carcinoma, but to the authors' knowledge few have included Asian/Pacific Islander (API) women. METHODS The population‐based study included API and non‐Hispanic white women diagnosed with localized invasive breast carcinoma in the Greater San Francisco Bay Area during 1994 (n = 1772). Multiple logistic regression was used to assess the association between race/ethnicity and type of surgery, radiation therapy following breast‐conserving surgery (BCS), and hormone therapy for estrogen receptor‐positive tumors while adjusting for demographic, medical, and census block‐group socioeconomic characteristics. RESULTS API women were significantly more likely to undergo mastectomies than white women (58% vs. 42%). This difference remained for Chinese and Filipino women after multivariate adjustment (odds ratio vs. whites [OR] = 2.4, 95% confidence interval [95% CI] = 1.4–4.2; OR [95%CI] = 1.8[1.0–3.1], respectively). Chinese women were also more likely than white women to not receive adjuvant therapy, be it radiation after BCS or hormone therapy for estrogen receptor‐positive disease. Other API women did not differ from white women in adjuvant therapy use. CONCLUSIONS This population‐based study identified differences in treatment for localized breast carcinoma by race/ethnicity that were not explained by differences in demographic, medical, or socioeconomic characteristics. These results underscore the importance of looking at treatment patterns separately for API subgroups and support the need for research into cultural differences that may influence breast carcinoma treatment choices. Cancer 2002;95:2268–75. © 2002 American Cancer Society. DOI 10.1002/cncr.10965