Comorbidties and Breast Cancer in the State of California

Principal Investigator: Professor Shagufta Yasmeen, M.D.

Funding for the project: National Institute of Health, K07

About 50% of women diagnosed with breast cancer are 65 years and older. Nearly half of these women present with metastatic disease. Black women have 10% higher risk of death than white women of similar age with the same stage at diagnosis of breast cancer. The number of comorbid conditions, such as diabetes and coronary artery disease, increases with age. Chronic medical conditions have a negative impact on breast cancer diagnosis, treatment and survival. The proposed study will help to determine the associations between clinically important comorbid conditions and stage at diagnosis, treatment and survival among breast cancer patients, taking into account variation by sociodemographic characteristics. This study will evaluate breast cancer screening in older women — or the lack of it — to help answer a much-debated question: When should breast cancer screening continue and when should it stop?

The fundamental aims of this project are 1) to identify the impact of chronic or “comorbid conditions” on decisions about whether or not to do mammograms; 2) to tease out what it is in the interaction between physicians and patients that influences decisions about screening; 3) and to determine what role other factors, such as race and ethnicity, play in an elderly woman’s willingness to undergo a mammography.

The results of this study will serve as basis for a new generation of patient guidelines to meet the needs of growing older population and address the disparities in breast cancer outcomes among minority women in the 21st century.