Oladeru, Oluwadamilola T.

Abstract Background Partial breast irradiation (PBI) is an effective treatment for early-stage breast cancer. However, evidence comparing different PBI modalities is limited. Methods This trial emulation uses electronic health records from a multi-state large tertiary health system. Three PBI modalities were compared: proton radiation therapy, photon radiation therapy, and applicator-based brachytherapy. Inverse probability weighting (IPW) was used to balance confounders. The primary outcome was ipsilateral breast recurrence (IBR). Results Between 2013 and 2023, 1041 women with early-stage breast cancer were treated with PBI. Of these, 1026 patients were included in the analyses. The median age was 66 years; 22.51% had ductal carcinoma in situ (DCIS), and 97.56% were estrogen receptor positive. With median follow-up of 38.2 months, the rate of IBR in the overall group was 3.05% (95% confidence interval [CI] = 1.99% to 4.65%) at 3 years. After IPW, compared with photon PBI, the hazard ratio for IBR for proton PBI was 2.11 (95% CI = 0.70 to 6.33) and for brachytherapy, 3.86 (95% CI = 1.39 to 10.69). Compared with proton PBI, the hazard ratio for IBR for brachytherapy was 1.83 (95% CI = 0.88 to 3.81). IBR risk was similar across PBI modalities for patients with tumor size ≤ 10 mm and in patients treated for DCIS. Among patients with tumor size >10 mm, the hazard ratio for IBR for brachytherapy was 7.64 (95% CI = 1.64 to 35.58) and 3.59 (95% CI = 1.22 to 10.56) relative to photons and protons, respectively. Conclusion PBI with applicator-based brachytherapy was associated with higher IBR than photon or proton PBI in patients with tumor size > 10 mm, suggesting the need for more careful PBI patient selection for this modality.

ImportanceAlthough incarceration is associated with worse cancer outcomes, little is known about quality of cancer care among people with a history of incarceration.ObjectiveTo describe quality of cancer care among those diagnosed with cancer during or immediately after incarceration.Design, Setting, and ParticipantsThis longitudinal cohort study used Connecticut Tumor Registry data linked to Department of Correction rosters from 2005 through 2016. Patients diagnosed with cancer while incarcerated were matched to those diagnosed within 12 months after incarceration and to those with no history of incarceration. Analysis was performed between March 2024 and January 2025.ExposuresIncarceration status at time of cancer diagnosis.Main Outcomes and MeasuresThe main outcomes were treatment initiation within 60 days and receipt of recommended pretreatment and therapeutic care, ascertained from medical records and tumor registries. Logistic regression was used to evaluate odds of treatment initiation by 60 days. The proportion of recommended elements of pretreatment and therapeutic care received was calculated, and group differences were assessed using χ2 tests.ResultsThe sample included 690 individuals (233 diagnosed during incarceration, 221 diagnosed within 12 months after incarceration, and 236 with no incarceration history). The mean (SD) age was 49.7 (12.1) years, and 611 (88.6%) were male. Compared with those with no history of incarceration, those diagnosed with cancer during incarceration were less likely to initiate treatment within 60 days (169 of 209 [80.9%] vs 131 of 189 [69.3%]; OR, 0.49 [95% CI, 0.31-0.79]). Initiation of treatment within 60 days was not statistically different for those diagnosed after incarceration vs those with no history of incarceration (144 of 187 [77.0%]; OR, 0.81 [95% CI, 0.49-1.34]). Those diagnosed with local and regional cancers during incarceration received 49.2% of recommended treatment-related care (31 of 63 measures), while those diagnosed after incarceration received 45.3% (34 of 75 measures), compared with 66.7% (36 of 54 measures) among those with no history of incarceration (P < .001). People diagnosed with local and regional cancers during incarceration received 80.6% of recommended pretreatment evaluation (54 of 67 measures), and those diagnosed after received 96.8% (59 of 68 measures), compared with 78.1% (50 of 64 measures) among those with no history of incarceration (P = .01).Conclusions and RelevanceIn this cohort study of people with a history of incarceration, incarceration was associated with lower likelihood of receiving timely, high-quality cancer treatment. Along with other published literature, this work suggests that gaps in quality of care may contribute to observed disparities in outcomes.

Abstract Background: Black women continue to face disproportionate mortality and long-term challenges after breast cancer treatment, including gaps in follow-up care, culturally relevant support, and access to survivorship resources. Digital tools designed with Black survivors in mind remain limited, despite their potential to reduce disparities in post-treatment engagement. Objective: To address these gaps, we developed HERCaRE (Health Equity Resources for Breast Cancer Responsive Education), a progressive web application (PWA) designed to deliver culturally responsive survivorship education and engagement tools to Black breast cancer survivors. HERCaRE was designed to meet the need for a culturally responsive, easily accessible resource that empowers survivors to engage more confidently in their post-treatment care. Methods: The concept for HERCaRE was informed by a previous pilot study on virtual breast health education, in which participants expressed the need for more sustained and accessible support for survivors. Building on that insight, the platform was developed with advisory input from Black breast cancer survivors and community advocates through informal, discussion-based feedback. While not a formal co-design process, this input helped ensure cultural relevance in tone, structure, and visual language. HERCaRE includes three core features: educational modules on key survivorship topics, interactive behavior-prompting activities, and a notes section for self-reflection and goal tracking. The platform is grounded in the Health Promotion Model and RE-AIM framework, providing a foundation for future implementation and evaluation. The platform is currently being prepared for pilot testing, which will assess usability, perceived relevance, and engagement frequency among Black breast cancer survivors. Mixed-method surveys and platform analytics will guide refinement ahead of broader implementation. Preliminary Insights: Early input emphasized the importance of affirming, plain-language content and simple navigation. Activities were designed to promote exploration of the educational material and personal health behaviors through simple, self-guided prompts. Current efforts are focused on content finalization, participant recruitment, and platform readiness for testing. Conclusion: HERCaRE offers a responsive, theory-informed approach to digital survivorship support for Black women. While still in the pre-implementation phase, its development reflects a commitment to accessible design, cultural alignment, and future scalability. The platform lays important groundwork for reducing disparities in survivorship care and expanding digital health tools that center the needs of historically underserved populations. HERCaRE’s modular design and emphasis on user experience position it for adaptation across diverse clinical and community settings, including integration into survivorship programs serving other medically underserved populations. Citation Format: Manisha Salinas, Timethia Bonner, Laura Pacheco-Spann, Oluwadamilola Oladeru, Dianne Townsend, Che Ngufor. A culturally tailored digital health platform to improve breast cancer survivorship for Black women: HERCaRE [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr B048.

Objectives: Breast cancer (BC) remains a critical public health issue where early detection significantly improves outcomes. Despite advancements, disparities in screening awareness and access persist, particularly in underserved populations. This study evaluates a comprehensive, technology-driven educational campaign designed to empower individuals to advocate for their breast health, bridging gaps in knowledge and accessibility. Methods: Between 10/1/22 and 12/2/22, a multiplatform campaign was conducted with IRB approval. The initiative utilized traditional media, including televised ads and educational videos, and digital tools such as a mobile app and website in English and Spanish. Central to this campaign was an interactive risk calculator, offering personalized BC screening recommendations. Data collection included user demographics, platform engagement metrics, and the identification of high-risk individuals. A cost-effectiveness analysis was conducted using campaign budget data. Results: The campaign reached 673,920 individuals through televised ads and 152,672 impressions by digital ads. The website garnered 930 unique impressions, while the app recorded 2752 downloads across 131 countries. The risk calculator was completed 637 times, identifying 72 high-risk individuals. Follow-up data revealed ongoing engagement, with the calculator used an additional 1468 times. The cost per conversion was $1.62, and the cost to identify a high-risk individual was $209.27, demonstrating remarkable cost-efficiency. Conclusions: This campaign successfully increased BC awareness and early detection efforts, leveraging a cost-effective, multiplatform approach. The integration of personalized tools like the risk calculator underscores the potential of digital interventions in health education. Future efforts should build on this model to further enhance reach and health outcomes.

Quadruple-negative breast cancer (QNBC) is a triple-negative breast cancer (TNBC) subtype that lacks expression of the androgen (AR) receptor. Few studies have focused on this highly aggressive breast cancer, portending worse survival rates. We aimed to determine the following: (1) QNBC’s molecular and clinical characteristics and compare them with other subtypes and (2) QNBC’s association with clinicopathological factors and prognostic markers. We performed immunohistochemical evaluations of ARs on tissue tumor microarrays from FFPE tumor blocks of invasive ductal breast carcinomas in 202 African American women. Univariate analysis was performed using the chi-square test, with survival rates calculated using Kaplan–Meier curves. Overall, 75.8% of TNBCs were AR-negative. Compared to the luminal subtypes, TNBC and QNBC tumors were likely to be a higher grade (p < 0.001); HER2+/AR- and QNBCs were also larger than the other subtypes (p < 0.001). They also expressed increasing mean levels of proteins involved in invasion, such as CD44, fascin, and vimentin, as well as decreasing the expression of proteins involved in mammary differentiation, such as GATA3 and mammaglobin. We found no association between QNBC and stage, recurrence-free survival, or overall survival rates. The high prevalence of TNBC AR-negativity in these women could explain observed worse outcomes, supporting the existence of the unique QNBC subtype.

Background . Despite the potential of palliative care (PC) to enhance the quality of life for patients with advanced dementia, there is limited knowledge of its inpatient utilization patterns. This study investigated inpatient PC consultation utilization patterns and evaluated its impact on hospital length of stay (LOS) and medical costs among older patients diagnosed with Alzheimer’s Disease and Related Dementia who were at a high risk of mortality (ADRD-HRM). Methods . Using the 2016-2019 National Inpatient Sample database, we conducted multivariable logistic regression analyses to identify individual and hospital characteristics influencing PC consultation utilization. We subsequently performed generalized linear models to estimate LOS (using Poisson distribution) and hospital charges (via log-transformation). Results . Our sample encompassed 965,644 hospital discharges (weighted n = 4,828,219) of patients aged 65 years and above with ADRD-HRM. Among them, 14.6% received inpatient PC. There was a notable uptrend in PC consultation utilization from 13.3% in 2016 to 16.3% in 2019 ( p trend<.001). Factors positively influencing and associated with PC utilization included patients that are older, non-Hispanic White, with higher income, receiving care from teaching hospitals, and facilitated with greater bed capacity (all P < .05). Although patients who received PC were more likely to have 3.0% longer LOS ( P < .001), they had 19.2% lower hospital charges ( P < .001). Conclusions . PC substantially reduced hospital expenditures for older patients with ADRD-HRM, but the prevalence remained low at 14.6% in the study period. Future studies should explore the unmet needs of patients with lower sociodemographic status and those in rural hospitals to further increase their PC consultation utilization.

Abstract There is a large and increasing rate of incarcerated individuals that face a risk of cancer. Cancer is the leading cause of death among the incarcerated population, resulting in a significantly shortened survival rate amongst said population. Very few studies have been conducted to truly assess the knowledge gap between incarceration and cancer outcomes. But, from the few that have been done, like the population-based study done by UF Radiation Oncology assistant professor, Dr. Oladeru, it was discovered that a higher risk of cancer mortality was prevalent in those who were diagnosed with cancer during their time incarcerated as well as one year post release than the general population. My goal and intent with this literature review is to open the conversation about possible ways to bridge the knowledge gap between cancer health disparities amongst incarcerated patients and contribution factors. Citation Format: Tamia Isaacs, Oluwadamilola Oladeru, Jian Li, Yoshiko Iwai. Bridging the gap: A literature review of cancer mortality and incarcerated individuals [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr C015.

PURPOSE Axillary soft tissue (AXT) involvement with tumor cells extending beyond the positive lymph node (LN+) and extracapsular extension (ECE) has been overlooked in breast pathology specimen analysis. MATERIALS AND METHODS We analyzed 2,162 LN+ patients, dividing them into four groups on the basis of axillary pathology: (1) LN+ only, (2) LN+ and ECE only, (3) LN+ and AXT without ECE, and (4) LN+ with both AXT and ECE. The primary end points were 10-year locoregional failure (LRF), the 10-year axillary failure, and 10-year distant metastasis rates. Multivariable Cox models, accounting for clinical factors, were fitted using the entire cohort, and subgroups analyses were conducted. RESULTS The median follow-up was 9.4 years. The 10-year distant metastasis incidence was 42% for LN + AXT + ECE, 23% for both LN + AXT and LN + ECE only, and 13% for LN+ only. The 10-year axillary failure rates were 4.5% for LN + AXT + ECE, 4.6% for LN + AXT, 0.8% for LN + ECE only, and 1.6% for LN+ only. The 10-year LRF rates were 14% for LN + AXT + ECE, 10% for LN + AXT, 5.7% for LN + ECE only, and 6.2% for LN+ only. Multivariable analysis revealed that AXT was significantly associated with distant metastasis (hazard ratio [HR], 1.6; P < .001), locoregional failure (HR, 2.3; P < .001), and axillary failure (HR, 3.3; P = .003). Subgroup analyses showed that regional LN radiation (RLNR) improved locoregional tumor outcomes with AXT, ECE, or both (HR, 0.5; P = .03). Delivering ≤50 Gy to the axilla in the presence of AXT/ECE increased axillary failure (HR, 3.0; P = .04). Moreover, when delivering RLNR, axillary LN dissection could be de-escalated to sentinel node biopsy even in the presence of features such as AXT or ECE without significantly increasing any failure outcome: (HR, 1.0; P = .92) for LRF, (HR, 1.1; P = .94) axillary failure, and (HR, 0.4; P = .01) distant metastasis. CONCLUSION Routine reporting of axillary tissue involvement, beyond LNs and ECE, is crucial in predicting breast cancer outcomes. Ruling out the presence of AXT is imperative before any form of axillary de-escalation, especially RLNR omission.