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The Landmark Series-Addressing Disparities in Breast Cancer Screening: New Recommendations for Black Women

Fayanju, Oluwadamilola M; Edmonds, Christine E; Reyes, Sylvia A; Arciero, Cletus; Bea, Vivian J; Crown, Angelena; Joseph, Kathie-Ann
Randomized, clinical trials have established the efficacy of screening mammography in improving survival from breast cancer for women through detection of early, asymptomatic disease. However, disparities in survival rates between black women and women from other racial and ethnic groups following breast cancer diagnosis persist. Various professional groups have different, somewhat conflicting, guidelines with regards to recommended age for commencing screening as well as recommended frequency of screening exams, but the trials upon which these recommendations are based were not specifically designed to examine benefit among black women. Furthermore, these recommendations do not appear to incorporate the unique epidemiological circumstances of breast cancer among black women, including higher rates of diagnosis before age 40 years and greater likelihood of advanced stage at diagnosis, into their formulation. In this review, we examined the epidemiologic and socioeconomic factors that are associated with breast cancer among black women and assess the implications of these factors for screening in this population. Specifically, we recommend that by no later than age 25 years, all black women should undergo baseline assessment for future risk of breast cancer utilizing a model that incorporates race (e.g., Breast Cancer Risk Assessment Tool [BCRAT], formerly the Gail model) and that this assessment should be conducted by a breast specialist or a healthcare provider (e.g., primary care physician or gynecologist) who is trained to assess breast cancer risk and is aware of the increased risks of early (i.e., premenopausal) and biologically aggressive (e.g., late-stage, triple-negative) breast cancer among black women.
PMID: 36192515
ISSN: 1534-4681
CID: 5351492

Diversity, Equity, and Inclusion in Clinical Trials

Keegan, Grace; Crown, Angelena; Joseph, Kathie-Ann
Minority groups are vastly underrepresented in clinical trial participants and leadership. Because these studies provide innovative and revolutionary treatment options to patients with cancer and have the potential to extend survival, it is imperative that public and private stakeholders, as well as hospital and clinical trial leadership, prioritize equity and inclusion of diverse populations in clinical trial development and recruitment strategies. Achieving equity in clinical trials could be an important step in reducing the overall cancer burden and mortality disparities in vulnerable populations.
PMID: 36410919
ISSN: 1558-5042
CID: 5372032

Invited Editorial on Breast Surgical Oncology Epidemiological Research: A Guide and Comparison of Four National Databases [Editorial]

Crown, Angelena; Joseph, Kathie-Ann
PMID: 36513907
ISSN: 1534-4681
CID: 5382122

ASO Visual Abstract: Landmark Series-Addressing Disparities in Breast Cancer Screening: New Recommendations for Black Women

Fayanju, Oluwadamilola M; Edmonds, Christine E; Reyes, Sylvia A; Arciero, Cletus; Bea, Vivian J; Crown, Angelena; Joseph, Kathie-Ann
PMID: 36310313
ISSN: 1534-4681
CID: 5365602

ASO Author Reflections: Same but Different: Implications of Surgical Delays for Breast Cancer Patients Treated in NYC Public Hospitals During the COVID-19 Pandemic

Escobar, Natalie; Joseph, Kathie-Ann
PMCID:9533985
PMID: 36197559
ISSN: 1534-4681
CID: 5351582

ASO Visual Abstract: An Analysis of COVID-19 on Surgical Delays in Breast Cancer Patients in NYC Public Hospitals-A Multicenter Study

Escobar, Natalie; DiMaggio, Charles; Pocock, Benjamin; Pescovitz, Allison; McCalla, Sydney; Joseph, Kathie-Ann
PMCID:9513008
PMID: 36161378
ISSN: 1534-4681
CID: 5334012

ASO Author Reflections: Optimizing Breast Cancer Risk Assessment and Screening Among Black Women

Crown, Angelena; Joseph, Kathie-Ann
PMID: 36138285
ISSN: 1534-4681
CID: 5335652

Effects of COVID-19 on Surgical Delays in Patients with Breast Cancer in NYC Public Hospitals: A Multicenter Study

Escobar, Natalie; DiMaggio, Charles; Pocock, Benjamin; Pescovitz, Allison; McCalla, Sydney; Joseph, Kathie-Ann
BACKGROUND:Increased time to surgery (TTS) is associated with decreased survival in patients with breast cancer. In early 2020, elective surgeries were canceled to preserve resources for patients with coronavirus disease 2019 (COVID-19). This study attempts to measure the effect of mandated operating room shutdowns on TTS in patients with breast cancer. PATIENTS AND METHODS/METHODS:This multicenter retrospective study compares 51 patients diagnosed with breast cancer at four public hospitals from January to June 2020 with 353 patients diagnosed from January 2017 to June 2018. Demographics, tumor characteristics, treatment regimens, and TTS for patients were statistically compared using parametric, nonparametric, and Cox proportional hazards regression modeling. RESULTS:Across all centers, there was a non-statistically significant increase in median TTS from 59 days in the pre-COVID period to 65 days during COVID (p = 0.9). There was, however, meaningful variation across centers. At center A, the median TTS decreased from 57 to 51 days, center C's TTS decreased from 83 to 64 days, and in center D, TTS increased from 42 to 129 days. In a multivariable Cox proportional hazards model for the pre-COVID versus COVID period effect on TTS, center was an important confounding variable, with notable differences for centers C and D compared with the referent category of center A (p = 0.04, p = 0.006). CONCLUSION/CONCLUSIONS:Data suggest that, while mandated operating room shutdowns did not result in an overall statistically significant delay in TTS, there were important differences between centers, indicating that, even in a unified multicenter public hospital system, COVID-19 may have resulted in delayed and potentially disparate care.
PMCID:9483518
PMID: 36109414
ISSN: 1534-4681
CID: 5332922

Addressing breast cancer surgical disparities using a community-clinical linkage patient navigation model strategy in a NYC hospital system [Editorial]

Joseph, Kathie-Ann
PMID: 35115173
ISSN: 1879-1883
CID: 5153842

ASO Visual Abstract: The Role of Safety Net Hospitals in Reducing Disparities in Breast Cancer Care

Crown, Angelena; Ramiah, Kalpana; Siegel, Bruce; Joseph, Kathie-Ann
PMID: 35385994
ISSN: 1534-4681
CID: 5204942