3237.0: Monday, October 22, 2001 - 5:30 PM

Abstract #24149

Timing and detection of breast cancer recurrence in a southwestern MCO

Therese E Goetz, PhD1, Christine A Stidley, PhD2, Floyd Frost, PhD3, Suzanne Monroy, RN, MA, OCN4, Kristine Tollestrup, PhD, MPH2, and Charles Key, MD, PhD5. (1) Masters in Public Health Program, University of New Mexico, 2400 Tucker NE, Albuquerque, NM 87131, (505) 299-1140, tegoetz@aol.com, (2) Department of Family and Community Medicine, University of New Mexico, (3) Southwest Center for Managed Care Research, (4) Lovelace Health Systems, (5) New Mexico Tumor Registry, University of New Mexico, Albuquerque, NM

Little is known about factors influencing the timing and detection of breast cancer relapses, and most research predates recent screening and treatment advances. Moreover, cancer relapses are not included in the NCI's SEER database. In this study we obtained a decade of data on breast cancer (618 cases with 99 relapsing) in a southwestern MCO with a large Hispanic population. We merged these with SEER data on prior cancers and survival. We assessed how breast cancer relapses were discovered in actual practice and how ethnicity (24% Hispanic, 76% non-Hispanic white), as well as age (30% 26-49, 30% 50-64, 40% 65-88) and AJCC stage (53% I, 40% II, 7% III) for first breast cancer were related to time-to-recurrence and time-to-death. At least 52% of recurrences were first detected by patients, compared to 19% by routine clinical tests/exams (unknown=27%). Mode of detection was unrelated to time-to-recurrence or demographic factors, including ethnicity. Kaplan-Meier survival curves for time-to-recurrence differed significantly across stage (p < 0.001), but not other factors. After adjustment for multiple factors in a proportional hazards model, the only significant predictor was stage (p < 0.005). Lack of ethnic differences and implications for follow-up surveillance of breast cancer are discussed.

Learning Objectives: (1) Discuss possible reasons for a lack of ethnic difference in the timing and detection of breast cancer relapse, in light of differences in breast cancer incidence. (2) Identify the primary mode of detection for breast cancer recurrence. (3) Evaluate guidelines for follow-up surveillance of breast cancer.

Keywords: Breast Cancer, Hispanic

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 129th Annual Meeting of APHA