Delay Time Linked to Reduced Survival in Breast Cancer
(HealthDay News) – For young women with breast cancer, a longer treatment delay time (TDT) is associated with decreased survival; and women with early-stage breast cancer with Medicaid are more likely to undergo mastectomy than those with private insurance, according to two studies published online April 24 in JAMA Surgery.
Erlyn C. Smith, MD, from the University of California in Irvine, and colleagues examined the impact of TDT on survival using data from 8,860 women aged 15–39 years with breast cancer. The researchers found that TDT of >6 weeks was significantly more common for Hispanic and African-American vs. non-Hispanic white women, for women with no or public insurance vs. private insurance, and for women with low vs. high socioeconomic status. For women treated by surgery with TDT of >6 weeks, the five-year survival was 80%, which was significantly lower than the 90% for those with TDT of <2 weeks.
Linda Adepoju, MD, from the University of Toledo Medical Center in Ohio, and colleagues examined the effect of insurance payer status on mastectomy rates for 1,539 women with early-stage breast cancer. The researchers found that, at diagnosis, women with Medicaid had significantly larger tumors and were more likely to be treated with mastectomy for large tumors than those with private insurance. Women with private insurance were significantly more likely to undergo mastectomy for smaller tumors. Overall, women with Medicaid were significantly more likely to undergo mastectomy than those with private insurance (60% vs. 39%).
"In summary, our study demonstrates that tumor size, cancer stage, and Medicaid insurance were predictors of mastectomy," Adepoju and colleagues write.