Disparities in the Management of Pediatric Breast Masses

Autor: Maria E. Knaus, Amanda J. Onwuka, Alexis Bowder, Cathleen Courtney, Katherine J. Deans, Cynthia D. Downard, Yara K. Duran, Mary E. Fallat, Jason D. Fraser, Samir K. Gadepalli, Rashmi Kabre, Elle L. Kalbfell, Jonathan Kohler, Dave R. Lal, Matthew P. Landman, Amy E. Lawrence, Charles M. Leys, Patricia Lu, Grace Z. Mak, Troy A. Markel, Naila Merchant, Tina Nguyen, Mercedes Pilkington, Elissa Port, Beth Rymeski, Jacqueline Saito, Thomas T. Sato, Shawn D. St Peter, Tiffany Wright, Peter C. Minneci, Julia E. Grabowski
Rok vydání: 2022
Předmět:
Zdroj: Journal of Surgical Research. 279:648-656
ISSN: 0022-4804
DOI: 10.1016/j.jss.2022.06.049
Popis: Disparities in surgical management have been documented across a range of disease processes. The objective of this study was to investigate sociodemographic disparities in young females undergoing excision of a breast mass.A retrospective study of females aged 10-21 y who underwent surgery for a breast lesion across eleven pediatric hospitals from 2011 to 2016 was performed. Differences in patient characteristics, workup, management, and pathology by race/ethnicity, insurance status, median neighborhood income, and urbanicity were evaluated with bivariate and multivariable regression analyses.A total of 454 females were included, with a median age of 16 y interquartile range (IQR: 3). 44% of patients were nonHispanic (NH) Black, 40% were NH White, and 7% were Hispanic. 50% of patients had private insurance, 39% had public insurance, and 9% had other/unknown insurance status. Median neighborhood income was $49,974, and 88% of patients resided in a metropolitan area. NH Whites have 4.5 times the odds of undergoing preoperative fine needle aspiration or core needle biopsy compared to NH Blacks (CI: 2.0, 10.0). No differences in time to surgery from the initial imaging study, size of the lesion, or pathology were observed on multivariable analysis.We found no significant differences by race/ethnicity, insurance status, household income, or urbanicity in the time to surgery after the initial imaging study. The only significant disparity noted on multivariable analysis was NH White patients were more likely to undergo preoperative biopsy than were NH Black patients; however, the utility of biopsy in pediatric breast masses is not well established.
Databáze: OpenAIRE
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