Factors Associated with Initial Mode of Breast Cancer Detection among Black Women in the Women’s Circle of Health Study
Table 3
Breast care characteristics prior to breast cancer diagnosis and tumor clinicopathologic features among Black women aged 40-75 years in the WCHS, overall and by initial mode of breast cancer detection.
Overall
Screening mammogram
Clinical breast exam
Self-detection
P-value
(N = 1643)
(n = 725)
(n = 63)
(n = 534)
N ()
n()
n()
n()
Breast care characteristics prior to breast cancer diagnosis
Ever received a doctor’s recommendation for a mammogram before breast cancer diagnosis
<0.001
No
274 (20.7)
103 (14.2)
16 (25.4)
155 (29.0)
Yes
1045 (79.1)
620 (85.5)
47 (74.6)
378 (70.8)
Ever had a routine screening mammogram before breast cancer diagnosis
<0.001
No
174 (13.2)
37 (5.1)
16 (25.4)
121 (22.7)
Yes
1148 (86.8)
688 (94.9)
47 (74.6)
413 (77.3)
Interval between breast cancer diagnosis and most recent routine screening mammogram
<0.001
<1 year
112 (8.5)
66 (9.1)
4 (6.4)
42 (7.9)
1 year
565 (42.7)
382 (52.7)
17 (27.0)
166 (31.1)
>1 year
377 (28.5)
186 (25.7)
17 (27.0)
174 (32.6)
Unknown
268 (20.3)
91 (12.6)
25 (39.7)
152 (28.5)
Ever had a doctor perform a clinical breast exam(s) (CBE) before breast cancer diagnosis
<0.001
No
183 (13.8)
91 (12.6)
4 (6.4)
88 (16.5)
Yes – last CBE performed within the last year
795 (60.1)
482 (66.5)
35 (55.6)
278 (52.1)
Yes – last CBE performed more than one year ago
332 (25.1)
146 (20.1)
23 (36.5)
163 (30.5)
Ever performed breast self-exams (BSEs) before breast cancer diagnosis
<0.001
No
283 (21.4)
197 (27.2)
25 (39.7)
61 (11.4)
Yes – BSEs performed less than once per month
375 (28.4)
184 (25.4)
24 (38.1)
167 (31.3)
Yes – BSEs performed at least once per month
657 (49.7)
338 (46.6)
14 (22.2)
305 (57.1)
Ever diagnosed with a benign breast disease before breast cancer diagnosis
0.042
No
839 (63.5)
443 (61.1)
42 (66.7)
354 (66.3)
Yes
476 (36.0)
281 (38.8)
20 (31.8)
175 (32.8)
Breast tumor clinicopathologic features
Tumor grade
<0.001
Well/moderately differentiated
608 (46.0)
357 (49.2)
36 (57.1)
215 (40.3)
Poorly differentiated
483 (36.5)
178 (24.6)
22 (34.9)
283 (53.0)
Unknown
231 (17.5)
190 (26.2)
5 (7.9)
36 (6.7)
SEER summary stage
<0.001
In situ
166 (12.6)
144 (19.9)
2 (3.2)
20 (3.8)
Localized
718 (54.3)
427 (58.9)
37 (58.7)
254 (47.6)
Regional/distant
376 (28.4)
115 (15.9)
23 (36.5)
238 (44.6)
Unstaged
15 (1.1)
5 (0.7)
1 (1.6)
9 (1.7)
Missing
47 (3.6)
34 (4.7)
0 (0.0)
13 (2.4)
Tumor size (cm)
<0.001
<1.0
509 (38.5)
413 (57.0)
15 (23.8)
81 (15.2)
1.0-2.0
356 (26.9)
196 (27.0)
22 (34.9)
138 (25.8)
>2.0
456 (34.5)
115 (15.9)
26 (41.3)
315 (59.0)
Unknown
1 (0.1)
1 (0.1)
0 (0.0)
0 (0.0)
Lymph node status
<0.001
Negative
814 (61.6)
500 (69.0)
38 (60.3)
276 (51.7)
Positive
378 (28.6)
119 (16.4)
21 (33.3)
238 (44.6)
Unknown
130 (9.8)
106 (14.6)
4 (6.4)
20 (3.8)
Lymphovascular invasion present
<0.001
No
856 (64.8)
487 (67.2)
45 (71.4)
324 (60.7)
Yes
207 (15.7)
59 (8.1)
11 (17.5)
137 (25.7)
Unknown
259 (19.6)
179 (24.7)
7 (11.1)
73 (13.7)
Estrogen receptor (ER) status
<0.001
ER+
972 (73.5)
573 (79.0)
56 (88.9)
343 (64.2)
ER-
346 (26.2)
148 (20.4)
7 (11.1)
191 (35.8)
Unknown
4 (0.3)
4 (0.6)
0 (0.0)
0 (0.0)
Molecular
<0.001
ER+/PR+/HER2-
745 (56.4)
431 (59.5)
44 (69.8)
270 (50.6)
ER+/PR+/HER2+
127 (9.6)
56 (7.7)
10 (15.9)
61 (11.4)
ER-/PR-/HER2+
78 (5.9)
33 (4.6)
1 (1.6)
44 (8.2)
ER-/PR-/HER2-
234 (17.7)
92 (12.7)
6 (9.5)
136 (25.5)
Unknown
138 (10.4)
113 (15.6)
2 (3.2)
23 (4.3)
Molecular subtypes were classified using surrogate classifications, based on immunohistochemistry expression of ER and PR, and overexpression of HER2 (by immunohistochemistry and/or fluorescence in situ hybridization) as reported in pathology records.
