Ductal carcinoma in situ (DCIS): posttreatment follow-up care among Latina and non-Latina White women

J Cancer Surviv. 2013 Jun;7(2):219-26. doi: 10.1007/s11764-012-0262-6. Epub 2013 Feb 14.

Abstract

Background: There is a lack of information about posttreatment care among patients with ductal carcinoma in situ (DCIS). This study compares posttreatment care by ethnicity-language and physician specialty among Latina and White women with DCIS.

Methods: Latina and White women diagnosed with DCIS between 2002 and 2005 identified through the California Cancer Registry completed a telephone survey in 2006. Main outcomes were breast surveillance, lifestyle counseling, and follow-up physician specialty.

Key results: Of 742 women (396 White, 349 Latinas), most (90 %) had at least one clinical breast exam (CBE). Among women treated with breast-conserving surgery (BCS; N = 503), 76 % had received at least two mammograms. While 92 % of all women had follow-up with a breast specialist, Spanish-speaking Latinas had the lowest specialist follow-up rates (84 %) of all groups. Lifestyle counseling was low with only 53 % discussing exercise, 43 % weight, and 31 % alcohol in relation to their DCIS. In multivariable analysis, Spanish-speaking Latinas with BCS had lower odds of receiving the recommended mammography screening in the year following treatment compared to Whites (OR 0.5; 95 % CI, 0.2-0.9). Regardless of ethnicity-language, seeing both a specialist and primary care physician increased the odds of mammography screening and CBE (OR 1.6; 95 % CI, 1.2-2.3 and OR 1.9; 95 % CI, 1.3-2.8), as well as having discussions about exercise, weight, and alcohol use, compared to seeing a specialist only.

Conclusions: Most women reported appropriate surveillance after DCIS treatment. However, our results suggest less adequate follow-up for Spanish-speaking Latinas, possibly due to language barriers or insurance access.

Implications for cancer survivors: Follow-up with a primary care provider in addition to a breast specialist increases receipt of appropriate follow-up for all women.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aftercare / economics
  • Aftercare / statistics & numerical data*
  • Alcohol Drinking / epidemiology
  • Breast Neoplasms / ethnology
  • Breast Neoplasms / therapy*
  • California / epidemiology
  • Carcinoma, Intraductal, Noninfiltrating / ethnology
  • Carcinoma, Intraductal, Noninfiltrating / therapy*
  • Communication Barriers
  • Comorbidity
  • Counseling / statistics & numerical data
  • Female
  • Healthcare Disparities / statistics & numerical data*
  • Hispanic or Latino / statistics & numerical data*
  • Humans
  • Insurance Coverage / statistics & numerical data
  • Language
  • Life Style
  • Mammography / statistics & numerical data
  • Mastectomy, Segmental
  • Office Visits / statistics & numerical data
  • Referral and Consultation / statistics & numerical data
  • Socioeconomic Factors
  • Survivors / statistics & numerical data*
  • White People / statistics & numerical data*