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 subtypea | <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) |
aMolecular 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.