Journal article
Multilevel predictors of guideline concordant needle biopsy use for non-metastatic breast cancer
Breast cancer research and treatment, Vol.190(1), pp.143-153
08/17/2021
DOI: 10.1007/s10549-021-06352-y
PMID: 34405292
Abstract
Purpose
Persistent breast cancer disparities, particularly geographic disparities, may be explained by diagnostic practice patterns such as utilization of needle biopsy, a National Quality Forum-endorsed quality metric for breast cancer diagnosis. Our objective was to assess the relationship between patient- and facility-level factors and needle biopsy receipt among women with non-metastatic breast cancer in the United States.
Methods
We examined characteristics of women diagnosed with breast cancer between 2004 and 2015 in the National Cancer Database. We assessed the relationship between patient- (e.g., race/ethnicity, stage, age, rurality) and facility-level (e.g., facility type, breast cancer case volume) factors with needle biopsy utilization via a mixed effects logistic regression model controlling for clustering by facility.
Results
In our cohort of 992,209 patients, 82.96% received needle biopsy. In adjusted models, the odds of needle biopsy receipt were higher for Hispanic (OR 1.04, Confidence Interval 1.01–1.08) and Medicaid patients (OR 1.04, CI 1.02–1.08), and for patients receiving care at Integrated Network Cancer Programs (OR 1.21, CI 1.02–1.43). Odds of needle biopsy receipt were lower for non-metropolitan patients (OR 0.93, CI 0.90–0.96), patients with cancer stage 0 or I (at least OR 0.89, CI 0.86–0.91), patients with comorbidities (OR 0.93, CI 0.91–0.94), and for patients receiving care at Community Cancer Programs (OR 0.84, CI 0.74–0.96).
Conclusion
This study suggests a need to account for sociodemographic factors including rurality as predictors of utilization of evidence-based diagnostic testing, such as needle biopsy. Addressing inequities in breast cancer diagnosis quality may help improve breast cancer outcomes in underserved patients.
Details
- Title: Subtitle
- Multilevel predictors of guideline concordant needle biopsy use for non-metastatic breast cancer
- Creators
- Anja Zgodic - Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Rural and Minority Health Research Center, Arnold School of Public Health, University of South CarolinaJan M Eberth - Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Rural and Minority Health Research Center, Arnold School of Public Health, University of South CarolinaBenjamin D Smith - Departments of Radiation Oncology and Health Services Research, The University of Texas MD Anderson Cancer CenterWhitney E Zahnd - Rural and Minority Health Research Center, Arnold School of Public Health, University of South CarolinaSwann A Adams - Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Cancer Survivorship Center, College of Nursing, University of South CarolinaBrian P McKinley - Division of Breast Surgery, Department of Surgery, Prisma HealthRonnie D Horner - Department of Health Service Research and Administration, College of Public Health, University of Nebraska Medical CenterMark A O’Rourke - Prisma Health Upstate Cancer Institute, School of Medicine, University of South CarolinaDawn W Blackhurst - Cancer Care Delivery Research, Prisma HealthMatthew F Hudson - Cancer Care Delivery Research, Prisma Health
- Resource Type
- Journal article
- Publication Details
- Breast cancer research and treatment, Vol.190(1), pp.143-153
- Publisher
- Springer US
- DOI
- 10.1007/s10549-021-06352-y
- PMID
- 34405292
- ISSN
- 0167-6806
- eISSN
- 1573-7217
- Grant note
- Seed Grant for Cancer Care Delivery Research / prisma health
- Language
- English
- Date published
- 08/17/2021
- Academic Unit
- Health Management and Policy
- Record Identifier
- 9984214792602771
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