Deconstructing a hot spot of advanced breast cancer among younger women in Middletown: An exploratory study on root causes

Researcher(s)

  • Mckenzie Yurcaba, Biological Sciences, Delaware State University

Faculty Mentor(s)

  • Scott Siegel, ChristianaCare Helen F. Graham Cancer Center and Research Institute,

Abstract

Background 

Preliminary research from the Helen F. Graham Cancer Center & Research Institute (HFGCCRI) identified an area in Middletown as a ‘hotspot’, or a geographical location with higher-than-average rates of breast cancer. The present study aims to examine cases (women under 50 with advanced breast cancer) and controls (women over 50 with advanced/non-advanced breast cancer) to determine if there are differences in screening rates and diagnoses.  

Methods 

Participants records (N = 104; 66% White) were reviewed from the HFGCCRI Cancer Registry who resided in the Middletown hotspot. Data, including clinical, family, primary care, and social factors was abstracted from ChristianaCare’s Eletronic Health Records (EHR) system. Patients diagnosed with non-advanced (Stage 1) were considered control and advanced (Stage 2a and greater) are cases. Mammograms were used to diagnose screening patients, and the patient or a physician established the clinical/symptomatic diagnosis. Data were stored in REDCap which was then used for descriptive, t-test, and chi-square analyses which were made between cases (n = 18) and controls (n = 86).  

Results 

The Case group (Mage = 44.00, SDage = 3.46; 44% Black) was composed of a significantly higher percentage of Black vs. White women. (p < 0.001). Clinical/Symptomatic diagnoses made up a significantly higher percentage of patients in the Case group (72%) compared to the Control group (28%): χ2 = (2, N = 104) = 8.978, p = 0.011. Groups did not significantly differ between any comorbidities, except for smoking, where the Control group (50%) reported significantly higher levels than the Case group (23%).  

Discussion 

Preliminary results displayed that the Middletown hotspot higher rates of clinical/symptomatic detection for women with advanced breast cancer under the age of 50. This highlights the need to further investigate screening recommendations that are being followed and that patients are being educated about their risk factors.