Table 5: Age-adjusted associations of breast care characteristics prior to breast cancer diagnosis and tumor clinicopathologic characteristics with initial mode of breast cancer detection among Black women aged 40-75 years.

Clinical breast exam compared to screening mammogramSelf-detection compared to screening mammogram
Age-adjustedAge-adjusted
OR (95% CI)OR (95% CI)

Breast care characteristics prior to breast cancer diagnosis
Ever received a doctor’s recommendation for a mammogram
 No1.00 (Referent)1.00 (Referent)
 Yes0.70 (0.34, 1.47)0.73 (0.53, 1.02)
Ever had a routine screening mammogram before breast cancer diagnosis
 No1.00 (Referent)1.00 (Referent)
 Yes0.24 (0.11, 0.55)0.38 (0.24, 0.60)
Interval between breast cancer diagnosis and most recent routine screening mammogram
 <1 year1.00 (Referent)1.00 (Referent)
 1 year0.84 (0.24, 3.00)0.71 (0.45, 1.12)
 >1 year1.99 (0.56, 7.03)1.59 (1.00, 2.54)
Ever had a doctor perform a clinical breast exam(s) (CBE) before diagnosis
 No1.00 (Referent)1.00 (Referent)
 Yes – last CBE performed within the last year1.47 (0.43, 4.99)0.43 (0.30, 0.61)
 Yes – last CBE performed more than one year ago4.23 (1.22, 14.62)1.13 (0.76, 1.67)
Ever performed breast self-exams (BSEs) before breast cancer diagnosis
 No1.00 (Referent)1.00 (Referent)
 Yes – BSEs performed less than once per month1.04 (0.54, 2.02)3.06 (2.06, 4.54)
 Yes – BSEs performed at least once per month0.37 (0.18, 0.78)3.42 (2.38, 4.93)
Ever diagnosed with a benign breast disease before breast cancer diagnosis
 No1.00 (Referent)1.00 (Referent)
 Yes0.84 (0.46, 1.55)0.90 (0.7, 1.17)
Breast tumor clinicopathologic features
Tumor grade
 Well/moderately differentiated1.00 (Referent)1.00 (Referent)
 Poorly differentiated0.95 (0.50, 1.81)2.44 (1.86, 3.21)
SEER summary stage
 In situ0.22 (0.05, 0.94)0.22 (0.12, 0.37)
 Localized1.00 (Referent)1.00 (Referent)
 Regional/distant2.93 (1.59, 5.39)3.21 (2.28, 4.47)
Tumor size (cm)
 <1.01.00 (Referent)1.00 (Referent)
 1.0-2.03.54 (1.64, 7.65)4.07 (2.85, 5.81)
 >2.07.26 (3.41, 15.44)14.64 (10.30, 20.80)
Lymph node status
 Negative1.00 (Referent)1.00 (Referent)
 Positive2.99 (1.62, 5.51)3.43 (2.58, 4.56)
Lymphovascular invasion present
 No1.00 (Referent)1.00 (Referent)
 Yes1.92 (0.88, 4.18)3.21 (2.24, 4.59)
Estrogen receptor (ER)
 ER+1.00 (Referent)1.00 (Referent)
 ER-0.40 (0.16, 1.03)2.06 (1.57, 2.70)
Molecular
 ER+/PR+/HER2-1.00 (Referent)1.00 (Referent)
 ER+/PR+/HER2+1.57 (0.69, 3.56)1.50 (0.98, 2.31)
 ER-/PR-/HER2+0.32 (0.04, 2.43)1.87 (1.12, 3.11)
 ER-/PR-/HER2-0.48 (0.17, 1.39)2.17 (1.56, 3.01)

As shown in Table 3, percent unknown for tumor characteristics in the overall study sample was as follows: tumor grade, 17.5%; SEER summary stage, 3.6%; tumor size (cm), 0.1%; lymph node status, 9.8%; lymphovascular invasion present, 19.6%; ER status, 0.3%; molecular subtype, 10.4%.
Molecular subtypes were classified using surrogate classifications, based on immunohistochemical expression of ER and PR and overexpression or amplification of HER2 (by immunohistochemistry or fluorescence in situ hybridization) as reported in pathology records.