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Breast Cancer Treatment among African American Women in North St. Louis, Missouri

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Abstract

Similar to disparities seen at the national and state levels, African American women in St. Louis, Missouri have higher breast cancer mortality rates than their Caucasian counterparts. We examined breast cancer treatment (regimens and timing) in a sample of African American breast cancer patients diagnosed between 2000 and 2008 while residing in a North St. Louis cluster (eight zip codes) of late stage at diagnosis. Data were obtained from medical record extractions of women participating in a mixed-method study of breast cancer treatment experiences. The median time between diagnosis and initiation of treatment was 27 days; 12.2 % of the women had treatment delay over 60 days. These findings suggest that treatment delay and regimens are unlikely contributors to excess mortality rates for African American women diagnosed in early stages. Conflicting research findings on treatment delay may result from the inconsistent definitions of treatment delay and variations among study populations. Breast cancer treatment delay may reduce breast cancer survival; additional research is needed to better understand the points at which delays are most likely to occur and develop policies, programs, and interventions to address disparities in treatment delay. There may also be differences in treatment-related survivorship quality of life; approximately 54 % of the women in this sample treated with mastectomies received breast reconstruction surgery. Despite the high reconstruction rates, most women did not receive definitive completion. African American women have higher reconstruction complication rates than Caucasian women; these data provide additional evidence to suggest a disparity in breast reconstruction outcomes by race.

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Acknowledgments

A Community-Based Approach to Improving Breast Cancer Services for African American Women Living in St. Louis is funded by a Susan G. Komen For The Cure® Vulnerable Community Grant (Grant SG-11-10005, Colditz, PI). This project was also supported by the Program for the Elimination for Cancer Disparities (PECaD) (National Institutes of Health-National Cancer Institute Community Network Program, U54 CA153460; Colditz, PI) and the Barnes-Jewish Foundation. We would like to thank the Executive Committee and community partners for the A Community-Based Approach to Improving Breast Cancer Services for African American Women Living in St. Louis. We would also like to thank the breast cancer survivors who participated in this study.

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Authors and Affiliations

  1. Department of Surgery, Division of Public Health Sciences, Washington University in St. Louis School of Medicine, 660 South Euclid, Campus Box 8100, St. Louis, MO, 63110, USA

    Shahnjayla K. Connors, Melody S. Goodman & Sarah Gehlert

  2. George Warren Brown of Social Work, Washington University in St. Louis, St. Louis, MO, USA

    Lailea Noel, Neeraja N. Chavakula & Sarah Gehlert

  3. Betty Jean Kerr People’s Health Centers, St. Louis, MO, USA

    Dwayne Butler

  4. Christian Hospital, St. Louis, MO, USA

    Sandi Kenkel

  5. St. Louis Effort for AIDS, St. Louis, MO, USA

    Cheryl Oliver

  6. Committed Caring Faith Communities, St. Louis, MO, USA

    Isaac McCullough

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  1. Shahnjayla K. Connors
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Correspondence to Shahnjayla K. Connors.

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Connors, S.K., Goodman, M.S., Noel, L. et al. Breast Cancer Treatment among African American Women in North St. Louis, Missouri. J Urban Health 92, 67–82 (2015). https://doi.org/10.1007/s11524-014-9884-5

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