{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T21:04:04Z","timestamp":1790111044010,"version":"4.0.1"},"reference-count":30,"publisher":"American Society of Clinical Oncology (ASCO)","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Oncol Pract"],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Molecular profiling (MP) informs precision oncology in estrogen receptor\u2013positive, human epidermal growth factor receptor 2\u2013negative (ER+\/HER2\u2212) breast cancer, yet uptake within Medicaid is poorly characterized. We assessed MP receipt and associated factors among Ohio Medicaid beneficiaries with nonmetastatic ER+\/HER2\u2212 breast cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study using linked Ohio Cancer Incidence Surveillance System and Medicaid claims data. Study patients were age 18-65 years, diagnosed between 2016 and 2020 with localized or regional-stage ER+\/HER2\u2212 breast cancer, and continuously enrolled in Medicaid for \u22656 months following diagnosis or until death. The primary outcome was MP (Oncotype DX or MammaPrint) within 6 months of diagnosis. Multivariable logistic regression estimated adjusted odds ratios (aORs) for MP by stage, sociodemographics, Medicaid enrollment features (stable enrollment, long-term care [LTC] status), and neighborhood opportunity (Ohio Opportunity Index [OOI]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 1,988 patients, 752 (37.8%) received MP. In adjusted analyses, MP receipt was lower in regional versus localized disease (aOR, 0.35, 95% CI, 0.28 to 0.42), among Black versus White women (aOR, 0.72, 95% CI, 0.56 to 0.91), among patients with income above versus below the federal poverty level (aOR, 0.73, 95% CI, 0.57 to 0.94), and among Medicaid LTC enrollees versus nonenrollees (aOR, 0.47, 95% CI, 0.33 to 0.66). MP receipt was higher among married versus single patients (aOR, 1.30, 95% CI, 1.01 to 1.67). Stable Medicaid enrollment showed a positive trend (aOR, 1.24, 95% CI, 0.98 to 1.58). OOI was not associated with MP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Fewer than 40% of Ohio Medicaid beneficiaries with localized or regional-stage ER+\/HER2\u2212 breast cancer received MP, with variation by clinical stage and sociodemographic factors. As Medicaid programs face fiscal and policy pressures, health systems should prioritize consistent implementation of clinically indicated MP, particularly among patients with regional-stage disease, Black patients, and long-term Medicaid enrollees.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/op-26-00255","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T19:59:13Z","timestamp":1790107153000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":0,"title":["Missed Precision: Gaps in Molecular Profiling Among Medicaid Patients With Estrogen Receptor\u2013Positive, Human Epidermal Growth Factor Receptor 2\u2013Negative Breast Cancer"],"prefix":"10.1200","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-5821-1159","authenticated-orcid":true,"given":"Trisha","family":"Lal","sequence":"first","affiliation":[{"name":"Department of Surgery, University Hospitals, Cleveland Medical Center, Cleveland, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2433-0685","authenticated-orcid":true,"given":"Long","family":"Vu","sequence":"additional","affiliation":[{"name":"Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5009-3150","authenticated-orcid":true,"given":"Reine","family":"Abou Zeidane","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University Hospitals Seidman Cancer Center and Case Western Reserve University, Cleveland, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Courtney","family":"Pisano","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University Hospitals Seidman Cancer Center and Case Western Reserve University, Cleveland, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1538-1884","authenticated-orcid":true,"given":"Jamie","family":"Shoag","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology, Oncology and Bone Marrow Transplant, Cleveland Clinic Children's Hospital, Cleveland, OH"},{"name":"Case Comprehensive Cancer Center, Cleveland, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1455-6758","authenticated-orcid":true,"given":"Richard S.","family":"Hoehn","sequence":"additional","affiliation":[{"name":"Department of Surgery, University Hospitals, Cleveland Medical Center, Cleveland, OH"},{"name":"Case Comprehensive Cancer Center, Cleveland, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8106-9581","authenticated-orcid":true,"given":"Siran M.","family":"Koroukian","sequence":"additional","affiliation":[{"name":"Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH"},{"name":"Case Comprehensive Cancer Center, Cleveland, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7458-9303","authenticated-orcid":true,"given":"Johnie","family":"Rose","sequence":"additional","affiliation":[{"name":"Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH"},{"name":"Case Comprehensive Cancer Center, Cleveland, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2362-2860","authenticated-orcid":true,"given":"Corey","family":"Speers","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University Hospitals Seidman Cancer Center and Case Western Reserve University, Cleveland, OH"},{"name":"Department of Radiation Oncology, University of Alabama, Birmingham, AL"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"key":"e_1_3_8_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41523-023-00551-0"},{"key":"e_1_3_8_3_2","doi-asserted-by":"publisher","DOI":"10.21037\/tcr-2025-803"},{"key":"e_1_3_8_4_2","volume-title":"Guidelines Detail","author":"NCCN","unstructured":"NCCN: Guidelines Detail. https:\/\/www.nccn.org"},{"key":"e_1_3_8_5_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.22.00069"},{"key":"e_1_3_8_6_2","unstructured":"ASCO: NRG-BR007: A phase III trial evaluating de-escalation of breast radiation (DEBRA) following breast-conserving surgery of stage 1 HR+ HER2- RS \u226418 breast cancer. 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CareSource","author":"Solutions CIW& M","unstructured":"Solutions CIW& M: Plan Documents. 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