16 A Miami Hospital’s Infrastructure to Help Decrease Late-Stage Breast Cancer Diagnosis and Improve Health Equity

Publication
Article
Miami Breast Cancer Conference® Abstracts Supplement42nd Annual Miami Breast Cancer Conference® - Abstracts
Volume 39
Issue 4
Pages: 75-76

16 A Miami Hospital’s Infrastructure to Help Decrease Late-Stage Breast Cancer Diagnosis and Improve Health Equity

16 A Miami Hospital’s Infrastructure to Help Decrease Late-Stage Breast Cancer Diagnosis and Improve Health Equity

Background/Significance

We previously demonstrated, using the National Cancer Database, that lower income and education levels are associated with a higher stage at diagnosis of breast cancer. Expanding on this work, we analyzed publicly available data in mortality rate, focusing on Homestead Hospital’s service area in Miami-Dade County where predominantly Hispanic and Black neighborhoods face significant socioeconomic challenges.

Design and Methods

Using Miami-Dade Matters and US Census data, we evaluated the age-adjusted death rate in Miami-Dade County ZIP codes while analyzing hospital baseline data to identify opportunities to enhance screening rates. A ZIP code in Homestead Hospital’s service area has the county’s highest age-adjusted breast cancer mortality rate at 39.1 deaths per 100,000 females. In addition, the lowest percentage of high school graduates (65.5%), lowest percentage of bachelor’s degree (6.6%), highest percentage of health uninsurance (33.3%), and highest percentage of people living in poverty (32.6%) compared with the rest of Miami-Dade County. In Fiscal Year1 (FY1) 24, only 23% of Homestead Hospital’s screening mammograms were performed in Black, Hispanic, and multiracial women, despite these groups comprising 93% of the local female population. In FY1 24, there were a total of 4336 screening mammograms and diagnostic mammograms at Homestead Hospital. Of these, 16.5% (n = 716) needed additional work-up. While White had 77% of the total tests, they represented 19.6% of the tests that needed additional work-up. Minority demographic groups had 23% of the total tests but represented 80.4% of those in need of additional work-up.

Status

Our findings highlight significant disparities in breast cancer screening and diagnostic follow-up among minority populations in Miami-Dade County. We are developing an infrastructure to improve screening rates and a safety net for our patient population to mitigate barriers for accessing care. We educated providers at a local federally qualified health center on identifying high-risk patients. We are integrating a prediagnostic Linkage Navigator to enhance diagnostic test completion by addressing barriers and ensuring seamless linkage. We are enhancing an existing electronic flagging alert system as a safeguard, building on lessons from infectious disease screening, to identify patients needing follow-up in real-time upon returning within the health system (Figure). We are developing a dashboard to track the impact of our interventions, displaying early data from our health system transformation to reduce late-stage breast cancer diagnoses in our community.

Figure. Flagging Alert System

Figure. Flagging Alert System

Articles in this issue

16 A Miami Hospital’s Infrastructure to Help Decrease Late-Stage Breast Cancer Diagnosis and Improve Health Equity
16 A Miami Hospital’s Infrastructure to Help Decrease Late-Stage Breast Cancer Diagnosis and Improve Health Equity
17 Salmonella and the Breast: A Literature Review of Salmonella-Induced Breast Abscesses
17 Salmonella and the Breast: A Literature Review of Salmonella-Induced Breast Abscesses
18 Tolerability of First-Line Treatment With Ribociclib for Metastatic Breast Cancer Using 2 Large US Data Sources
18 Tolerability of First-Line Treatment With Ribociclib for Metastatic Breast Cancer Using 2 Large US Data Sources
20 Impact of Ribociclib Dose Reduction on Efficacy in Patients With Hormone Receptor-Positive/Human Epidermal Growth Factor Receptor 2-Negative Early Breast
20 Impact of Ribociclib Dose Reduction on Efficacy in Patients With Hormone Receptor-Positive/Human Epidermal Growth Factor Receptor 2-Negative Early Breast
21 Distant Disease-Free Survival Across Key Subgroups From the Phase 3 NATALEE Trial of Ribociclib Plus a Nonsteroidal Aromatase Inhibitor in Patients With HR+/HER2− Early Breast Cancer
21 Distant Disease-Free Survival Across Key Subgroups From the Phase 3 NATALEE Trial of Ribociclib Plus a Nonsteroidal Aromatase Inhibitor in Patients With HR+/HER2− Early Breast Cancer
22 Efficacy and Safety of Ribociclib + Nonsteroidal Aromatase Inhibitor in Younger Patients With HR+/HER2− Early Breast Cancer in NATALEE
22 Efficacy and Safety of Ribociclib + Nonsteroidal Aromatase Inhibitor in Younger Patients With HR+/HER2− Early Breast Cancer in NATALEE
23 Clinical Outcomes in Patients With HR+/HER2− Early Breast Cancer By Prior Systemic Treatment: A Subgroup Analysis of the NATALEE Trial
23 Clinical Outcomes in Patients With HR+/HER2− Early Breast Cancer By Prior Systemic Treatment: A Subgroup Analysis of the NATALEE Trial
TPS 24 Phase Ib Dose-Finding Study of [177Lu]Lu-NeoB + Ribociclib + Fulvestrant in Patients With ER+/HER2− Advanced Breast Cancer With GRPR Expression With Early Relapse FromAdjuvant Endocrine Therapy or Progression on ET + CDK4/6i for ABC
TPS 24 Phase Ib Dose-Finding Study of [177Lu]Lu-NeoB + Ribociclib + Fulvestrant in Patients With ER+/HER2− Advanced Breast Cancer With GRPR Expression With Early Relapse FromAdjuvant Endocrine Therapy or Progression on ET + CDK4/6i for ABC
TPS 25 Phase 1/2 Study of the Novel Radioligand Therapy [177Lu]Lu-NeoB Plus Capecitabine in Patients With ER+/HER2− Advanced Breast Cancer (ABC) With GRPR Expression After Progression on Prior Endocrine Therapy Plus a CDK4/6 Inhibitor for ABC
TPS 25 Phase 1/2 Study of the Novel Radioligand Therapy [177Lu]Lu-NeoB Plus Capecitabine in Patients With ER+/HER2− Advanced Breast Cancer (ABC) With GRPR Expression After Progression on Prior Endocrine Therapy Plus a CDK4/6 Inhibitor for ABC
26 Risk of Recurrence in Real-World NATALEE- and monarchE-Eligible Populations of Patients With HR+/HER2− Early Breast Cancer in an Electronic Health Record-Derived Database
26 Risk of Recurrence in Real-World NATALEE- and monarchE-Eligible Populations of Patients With HR+/HER2− Early Breast Cancer in an Electronic Health Record-Derived Database
27 Elacestrant vs Standard of Care in ER+, HER2- Advanced or Metastatic Breast Cancer With ESR1-Mutated Tumors: ESR1 Allelic Frequencies and Clinical Activity From the Phase 3 EMERALD Trial
27 Elacestrant vs Standard of Care in ER+, HER2- Advanced or Metastatic Breast Cancer With ESR1-Mutated Tumors: ESR1 Allelic Frequencies and Clinical Activity From the Phase 3 EMERALD Trial
TPS 28 ELEGANT: Elacestrant VS Standard Endocrine Therapy in Women and Men With Node-Positive, Estrogen Receptor-Positive, HER2-Negative, Early Breast Cancer With High Risk of Recurrence in a Global, Multicenter, Randomized, Open-Label Phase 3 Study
TPS 28 ELEGANT: Elacestrant VS Standard Endocrine Therapy in Women and Men With Node-Positive, Estrogen Receptor-Positive, HER2-Negative, Early Breast Cancer With High Risk of Recurrence in a Global, Multicenter, Randomized, Open-Label Phase 3 Study
29 A Real-World Exploratory Analysis to Identify Disparities in Breast Cancer Tumor Biopsy Practice at Community Oncology Clinics in the United States
29 A Real-World Exploratory Analysis to Identify Disparities in Breast Cancer Tumor Biopsy Practice at Community Oncology Clinics in the United States
30 Imlunestrant, an Oral Selective Estrogen Receptor Degrader, as Monotherapy and Combined With Abemaciclib, for Patients with ER+, HER2– Advanced Breast Cancer, Pretreated With Endocrine Therapy: Results of the Phase 3 EMBER-3 Trial
30 Imlunestrant, an Oral Selective Estrogen Receptor Degrader, as Monotherapy and Combined With Abemaciclib, for Patients with ER+, HER2– Advanced Breast Cancer, Pretreated With Endocrine Therapy: Results of the Phase 3 EMBER-3 Trial
TPS 31 Real-World Sacituzumab Govitecan Treatment Patterns and Outcomes in Second-Line or Later Metastatic Triple-Negative Breast Cancer: Leveraging Electronic Health Records and Manual Curation of a US Database
TPS 31 Real-World Sacituzumab Govitecan Treatment Patterns and Outcomes in Second-Line or Later Metastatic Triple-Negative Breast Cancer: Leveraging Electronic Health Records and Manual Curation of a US Database

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