Table 6: Multivariable logistic regression analysis of the factors associated with mode of detection among Black women aged 40-75 years.

CharacteristicClinical breast exam compared to screening mammogramSelf-detection compared to screening mammogram
Multivariable-adjustedMultivariable-adjusted
OR (95% CI)OR (95% CI)

Primary health insurance at diagnosis
 Private1.00 (Referent)1.00 (Referent)
 Medicaid0.99 (0.31, 3.15)1.03 (0.59, 1.82)
 Medicare1.84 (0.63, 5.38)0.83 (0.48, 1.43)
 Uninsured0.58 (0.14, 2.37)1.38 (0.77, 2.47)
 Other0.31 (0.04, 2.63)0.92 (0.46, 1.83)
Body mass index (kg/m2)
 <25.01.33 (0.49, 3.62)2.46 (1.52, 3.98)
 25.0-29.990.79 (0.32, 1.95)1.07 (0.70, 1.64)
 30.0-34.991.22 (0.50, 2.97)0.80 (0.50, 1.26)
 ≥35.01.00 (Referent)1.00 (Referent)
History of hormone therapy use
 No1.00 (Referent)1.00 (Referent)
 Yes0.61 (0.23, 1.63)0.62 (0.39, 0.97)
Ever had a routine screening mammogram before breast cancer diagnosis
 No1.00 (Referent)1.00 (Referent)
 Yes0.20 (0.07, 0.54)0.52 (0.27, 1.00)
Ever had a doctor perform a clinical breast exam(s) (CBE) before breast cancer diagnosis
 No1.00 (Referent)1.00 (Referent)
 Yes – last CBE performed within the last year4.33 (0.90, 20.83)0.48 (0.29, 0.79)
 Yes – last CBE performed more than one year ago11.04 (2.24, 54.55)1.28 (0.74, 2.20)
Ever performed breast self-exams (BSEs) before breast cancer diagnosis
 No1.00 (Referent)1.00 (Referent)
 Yes – BSEs performed less than once per month0.92 (0.42, 2.01)4.08 (2.45, 6.78)
 Yes – BSEs performed at least once per month0.31 (0.13, 0.74)4.99 (3.13, 7.97)
Breast tumor clinicopathologic features
Tumor gradea
 Well/moderately differentiated1.00 (Referent)1.00 (Referent)
 Poorly differentiated0.65 (0.28, 1.47)1.19 (0.80, 1.77)
SEER summary stage
 In situ0.44 (0.02, 9.20)0.65 (0.21, 2.05)
 Localized1.00 (Referent)1.00 (Referent)
 Regional/distant4.39 (0.78, 24.83)1.98 (0.92, 4.27)
Tumor size (cm
 <1.01.00 (Referent)1.00 (Referent)
 1.0-2.02.13 (0.83, 5.44)2.92 (1.84, 4.64)
 >2.03.17 (0.88, 11.42)6.41 (3.30, 12.46)
Lymph node
 Negative1.00 (Referent)1.00 (Referent)
 Positive1.54 (0.54, 4.34)1.62 (0.93, 2.81)
Lymphovascular invasion
 No1.00 (Referent)1.00 (Referent)
 Yes1.18 (0.48, 2.87)1.35 (0.84, 2.18)
Estrogen receptor (ER)
 ER+1.00 (Referent)1.00 (Referent)
 ER--1.13 (0.42, 3.07)
Molecular
 ER+/PR+/HER2-1.00 (Referent)1.00 (Referent)
 ER+/PR+/HER2+1.44 (0.53, 3.91)1.08 (0.61, 1.91)
 ER-/PR-/HER2+-1.44 (0.45, 4.63)
 ER-/PR-/HER2--1.69 (0.59, 4.82)

Note: odds ratios (ORs) and 95% confidence intervals (Cis) were generated using multivariable models, mutually adjusting for all variables shown in the table as well as for age.
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.