Breast cancer diagnosis and patterns of treatment: does being Indigenous make a difference? — ASN Events

Breast cancer diagnosis and patterns of treatment: does being Indigenous make a difference? (#715)

Suzanne P Moore 1 , Adèle C Green 1 , Gail Garvey 2 , Michael Coory 3 , Jennifer Martin 4 , Patricia C Valery 2
  1. Queensland Institute of Medical Research, Brisbane, Queensland, Australia
  2. Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
  3. Cancer Council Victoria, Melbourne, Victoria, Australia
  4. School of Medicine, University of Queensland, Brisbane, Queensland, Australia

Background: Indigenous Australians with cancer in general receive less cancer treatment, take longer to receive their treatment, and have poorer cancer outcomes than non-Indigenous Australians; however, the comparative outcomes for Indigenous women with breast cancer are largely unknown. We have therefore compared diagnosis, treatment, and presence of comorbidity in Indigenous and non-Indigenous Australian women diagnosed with breast cancer.
Methods: Through a matched cohort design we compared all Indigenous women (n=110) treated in Queensland public hospitals (1998-2004) to a frequency-matched (age, place of residence) random sample of non-Indigenous women (n=105). Clinical data were abstracted from records at public hospitals to a standard form.
Results: At diagnosis, Indigenous women had an average age of 54 years, were more likely to be highly socioeconomically disadvantaged (43% vs. 20% for non-Indigenous women; p<0.01), to have serious comorbidity (diabetes, cardiovascular disease; p<0.01), and more advanced disease than non-Indigenous women (regional/metastatic spread 51% vs. 36%, respectively; p=0.03). There was no difference in the histological types of tumours (p= 0.46), the proportions of oestrogen and progesterone receptor positive tumours (approximately 80%; P=0.92 and 70%; p=0.76 respectively), in time from diagnosis to treatment (p=0.26), treatment completion rates (p>0.05), mode of treatment (lumpectomy vs. mastectomy; p=0.17), or rates of tamoxifen use (p=0.17) between groups.
Conclusions: In Queensland, Indigenous women with breast cancer generally received comparable treatment to their non-Indigenous counterparts. Differences in comorbidity and stage at diagnosis between the two groups reinforce the need for early detection and improved management of co-existing disease in Indigenous women with breast cancer.