Journal article
Multilevel predictors of guideline concordant needle biopsy use for non-metastatic breast cancer
Breast cancer research and treatment, v 190(1), pp 143-153
01 Nov 2021
PMID: 34405292
Featured in Collection : UN Sustainable Development Goals @ Drexel
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.
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Details
- Title
- Multilevel predictors of guideline concordant needle biopsy use for non-metastatic breast cancer
- Creators
- Anja Zgodic - University of South CarolinaJan M. Eberth - University of South CarolinaBenjamin D. Smith - The University of Texas MD Anderson Cancer CenterWhitney E. Zahnd - Office of Minority HealthSwann A. Adams - University of South CarolinaBrian P. McKinley - Prisma HealthRonnie D. Horner - University of Nebraska Medical CenterMark A. O'Rourke - PrismaDawn W. Blackhurst - Prisma HealthMatthew F. Hudson - Prisma Health
- Publication Details
- Breast cancer research and treatment, v 190(1), pp 143-153
- Publisher
- Springer Nature
- Number of pages
- 11
- Grant note
- Prisma Health Seed Grant for Cancer Care Delivery Research
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Health Management and Policy
- Web of Science ID
- WOS:000685577600001
- Scopus ID
- 2-s2.0-85112778568
- Other Identifier
- 991021855277404721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Oncology