Breast tumor size at first presentation in Haitian breast cancer patients treated in a large U.S. safety net hospital: initial
Hashm, Faoz Abdulsalam A.
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This study assessed the tumor size at the time of first presentation of Haitian breast cancer patients compared to Non-Haitian Black and White patient populations of a large safety net hospital as an objective measure of diagnosis and treatment delay. Studies have shown that race and ethnicity have an influence in determining the breast cancer stage, treatment, and mortality rates. However, when we looked at the rates of breast cancer, screening among Black subgroups, such as Haitian women, was assessed and remained unclear because national studies do not differentiate Haitians from other Black populations. Two population-based studies that investigated breast cancer screening among Haitian women suggest that screening rates among Haitian women are lower than that of White and Black women. For this reason, many studies are diagnosed at later stages. This study to aimed to improved patient education. In this IRB approved retrospective study used the hospital electronic medical records and the cancer registry of breast cancer patients treated between 2013-2015. Female and male patients with primary breast cancer treated with surgery, complete imaging and medical data sets were included; patients with recurrent breast cancer or incomplete data sets were excluded. Demographics/race/ethnicity, tumor type and stage, receptor status, onco-type, proliferation rate as well as tumor size by radiology and pathology were recorded. vii Statistical analysis using ANOVA, T-test, U-test and Kruskal-Wallis, compared mean and median tumor sizes. In this study only tumor size was analyzed and reported. The results show 57/125 (45.6%) Haitian Black patients, 27/125 (21.6%) Non-Hispanic White, 41/125 (32.8%), Non-Haitian Black were included in the initial analysis of this study. The mean tumor size of Haitian Black (mean=3.09 cm, SD 2.91; median=2.3cm) was significantly larger compared to Black (mean=2.07cm, SD=1.77; median=1.6cm; p=0.022) or White (mean=1.88, SD=1.26; median=1.4; p = 0.008) patients. There was no significant difference in tumor size between Non-Haitian Black and White patients. Haitian Breast Cancer patients present with significantly larger tumors when compared to other patient populations. Improved patient education and intensified out-reach programs are needed to counteract this marked delay in initial diagnosis and treatment. Education and socio-economic differences must be further evaluated and all possible cofactors are needed to determine the most effective interaction to counteract this disparity.