About

Alina M. Mateo, M.D., is an Associate Professor of Clinical Surgery at the Perelman School of Medicine at the University of Pennsylvania. She is an active surgeon practicing at Pennsylvania Hospital, Penn Presbyterian Medical Center, and the Hospital of the University of Pennsylvania in Philadelphia. Dr. Mateo serves as the Director of the Integrated Breast Center at Pennsylvania Hospital and is involved in various surgical activities, including the Co-Worker Observation and Reporting System (CORS) at Pennsylvania Hospital. Her educational background includes a B.A. from the University of Miami, an M.S. and M.D. from Drexel University College of Medicine. Her research and clinical interests focus on breast surgery, addressing disparities in breast cancer outcomes, and examining sociodemographic factors affecting pediatric breast cancer. She has contributed to discussions on direct-to-consumer testing and breast cancer awareness, and her work emphasizes improving patient care and addressing disparities in breast cancer treatment and outcomes.

Research topics

• Medicine
• Nursing
• Environmental health
• Emergency medicine
• Internal medicine
• Demography
• Family medicine

Selected publications

• ASO Visual Abstract: Association Between Delayed/Forgone Medical Care and Resource Utilization Among Women with Breast Cancer in the United States

  Annals of Surgical Oncology · 2025-01-23

  article
  PublisherDOI

• Association of Neighborhood Deprivation with Stage at Diagnosis and Treatment Delay for Breast Cancer in Philadelphia

  Annals of Surgical Oncology · 2025-05-12 · 2 citations

  articleOpen access

  INTRODUCTION: Neighborhood deprivation and other sociodemographic factors are associated with breast cancer outcomes, but in Philadelphia, the country's poorest large city, these factors have been understudied. We examined their association with stage at breast cancer diagnosis and treatment delay (>60 days after diagnosis). METHODS: We identified women aged ≥18 years with breast cancer at an academic health system based in Philadelphia from 2011 to 2019. The Area Deprivation Index (ADI) was calculated across the cohort and grouped into quartiles: ADI 1 = least deprived, ADI 4 = most deprived. Multivariable logistic regression estimated sociodemographic associations with advanced stage (III-IV) at diagnosis and treatment delay. RESULTS: Overall, 11,108 patients were identified. White patients constituted a larger proportion of the least versus most deprived group (ADI 1 = 84.4% vs. ADI 4 = 50.9%), while the proportion of Black patients was highest in the most deprived group (ADI 1 = 3.9% vs. ADI 4 = 41.5%). Patients in the ADI 4 group (vs. ADI 1; odds ratio [OR] 1.48, 95% confidence interval [CI] 1.19-1.84), who identified as Black (vs. White; OR 1.35, 95% CI 1.11-1.63), and with Medicaid insurance (OR 1.94, 95% CI 1.51-2.49) or no insurance (OR 2.21, 95% CI 1.27-3.67) versus privately insured patients had higher odds of presenting with advanced stage (all p < 0.05). Patients who identified as Asian, had Medicaid insurance or no insurance, were >70 years of age, and presented with advanced stage were less likely to receive treatment within 60 days, while patients in the ADI 2-4 group were twice as likely to receive treatment within 60 days as patients in the ADI 1 group. CONCLUSIONS: Neighborhood deprivation was associated with advanced stage at presentation, but not treatment delay, for patients with breast cancer in the Philadelphia metropolitan area, suggesting neighborhood-level opportunities to facilitate screening and more early-stage diagnoses.

  PublisherOA PDFDOI

• ASO Visual Abstract: Association of Neighborhood Deprivation with Stage at Diagnosis and Treatment Delay for Breast Cancer in Philadelphia

  Annals of Surgical Oncology · 2025-06-11

  article
  PublisherDOI

• The Effect of Rurality on Time to Surgery and Overall Survival among Women with Breast Cancer

  Annals of Surgery · 2025-03-27 · 2 citations

  articleOpen accessCorresponding

  OBJECTIVE: How does distance to care affect time to surgery (TTS) and overall survival (OS) among rural patients with breast cancer? SUMMARY BACKGROUND DATA: TTS>60 days is associated with known sociodemographic characteristics and worse OS after breast cancer diagnosis, but the relationship between rurality, proximity to care, TTS, and OS remains unknown. METHODS: We identified females≥18 years with stage 0-III breast cancer diagnosed 2004-2019 who received upfront surgery in the National Cancer Database. Mediation and Cox proportional hazards analyses were conducted to assess the relationship between rurality, distance to treatment facility, prolonged TTS (i.e., >60 days), and OS. RESULTS: Of 1,979,194 patients meeting inclusion criteria, 1.4% resided in rural areas. In the multivariate mediation analysis, the total effect of rurality on prolonged TTS corresponded to an aOR of 0.89 (95% CI 0.86-0.93), the direct effect corresponded to an aOR of 0.84 (95% CI 0.79-0.89), and the indirect effect corresponded to an aOR of 1.10 (95% CI 1.09-1.10). Over 50% of the total effect of rurality on prolonged TTS was mediated by proximity to treatment facility. After adjusting for clinical and sociodemographic factors, TTS of 61-90 days was associated with worse OS in both rural (HR 1.37, 95% CI 1.14-1.63) and urban (HR 1.75, 95% CI 1.72-1.78) patients with comparable results observed for TTS >90 days. CONCLUSIONS: Although geographic proximity to care mediates the relationship between rurality and prolonged TTS, rurality has an intrinsic protective effect on TTS that is independent of the adverse effect of increased distance to care.

  PublisherOA PDFDOI

• Association Between Delayed/Forgone Medical Care and Resource Utilization Among Women with Breast Cancer in the United States

  Annals of Surgical Oncology · 2024 · 2 citations

  • Medicine
  • Emergency medicine
  • Family medicine

  BACKGROUND: Although high treatment costs of breast cancer care are well documented, the relationship between delayed/forgone (D/F) care and resource utilization among patients with breast cancer is unknown. This study sought to investigate the relationship between D/F care, resource use, and healthcare expenditures among patients with breast cancer. METHODS: Data on adult female patients with breast cancer were obtained from the Medical Expenditure Panel Survey to assess resource utilization and expenditures in the United States from 2007 to 2017. Weighted proportions of patients with ≥ 1 emergency department, ≥ 1 inpatient, ≥ 1 outpatient, and > 5 office-based encounters were compared between those experiencing D/F care versus those who did not using Rao-Scott adjusted chi-squared tests. Annual, per capita total, out-of-pocket, emergency department, inpatient, outpatient, office-based visit, and prescription medication expenditures were compared by using two-part econometric models. RESULTS: Five percent of patients with breast cancer experienced D/F care, and 42.9% of patients cited financial barriers as the primary reason for D/F care. In unweighted estimates, there were higher proportions of patients with ≥ 1 hospitalizations (37% vs. 16%, P < 0.001) among those experiencing D/F care versus those who did not. Patients with D/F care had $5372 (95% CI $35-$10,709, P = 0.04) higher per capita inpatient expenditures than patients without D/F care. CONCLUSIONS: Delayed/forgone care is associated with increased resource utilization and healthcare spending among breast cancer patients. Further work is needed to address the root causes of D/F breast cancer care, with a view to mitigating disparate outcomes and increasing costs.

  PublisherOA PDFDOI

• Patterns of Care and Efficacy of Chemotherapy and Radiotherapy in Skin-Involved Breast Cancers of All Sizes

  Clinical Breast Cancer · 2019-02-15 · 4 citations

  articleOpen access1st author
  PublisherOA PDFDOI

• Time to Surgery and the Impact of Delay in the Non-Neoadjuvant Setting on Triple-Negative Breast Cancers and Other Phenotypes

  Annals of Surgical Oncology · 2019-11-11 · 48 citations

  articleOpen access1st authorCorresponding
  PublisherOA PDFDOI

• Breast conservation versus mastectomy in patients with T3 breast cancers (&gt; 5 cm): an analysis of 37,268 patients from the National Cancer Database

  Breast Cancer Research and Treatment · 2018-10-20 · 23 citations

  article
  PublisherDOI

• Time to surgery and the impact of delay on triple negative breast cancers and other phenotypes.

  Journal of Clinical Oncology · 2018-05-20 · 6 citations

  article1st authorCorresponding

  e12606 Background: Triple negative (TN) breast cancer has a higher and earlier rate of distant events. It has been suggested that this behavior necessitates earlier surgical intervention for TNs than other breast cancers, and systemic therapy (neoadjuvant chemotherapy [NACT]) if time to surgery is not rapid. This study was performed to determine if preoperative delays more adversely impact TNs than other breast cancer phenotypes. Methods: Women diagnosed from 2004 through 2014 with Stage I - III breast cancers were reviewed from the National Cancer Database (NCDB). Phenotypes were assessed as TN (ER-, PR-, HER2-) hormone receptor positive (HR+) (ER+ and/or PR+, HER2-) and HER2-positive (HER2+) (ER+/-, PR+/-, HER2+). Delays were analyzed continuously as days from diagnosis to surgery and chemotherapy. Quantile regression was used to characterize median delays, and overall survival (OS) was analyzed using Cox proportional hazards models with interactions between delays and phenotype. Results: 351,088 patients met criteria, including 36,505 (10.4%) TNs, 77.9% HR+ and 11.7 % HER2+. Phenotype, among other factors, was predictive of treatment delays. Adjusted median days from diagnosis to surgery and chemotherapy were 29.9, 31.6, and 31.5, (p< 0.0001) and 72.7, 78.0, and 74.4 (p< 0.0001), respectively. Per month of delay to surgery, OS declined for all patients (HR 1.104, p< 0.0001). For chemotherapy recipients, delays per month also lowered OS: diagnosis to surgery (HR 1.085, p< 0.0001); surgery to chemotherapy (HR 1.101, p< 0.0001), with no difference in the effect during these intervals (p= 0.46). In models separating or combining surgery and chemotherapy, adjusting for demographic, tumor, and treatment factors, this survival decline did not vary by breast cancer phenotype (p-values > 0.3). Conclusions: Delays cause small but measurable effects overall, but there are no differences in survival between breast cancer phenotypes from increasing preoperative delay. Our data suggest that urgency between diagnosis and surgery or diagnosis and chemotherapy is not greater for TN breast cancers. Although NACT is advocated to avoid treatment delays, this study does not identify a differential impact of timing on OS.

  PublisherDOI

• Atypical medullary carcinoma of the breast has similar prognostic factors and survival to typical medullary breast carcinoma: 3,976 cases from the National Cancer Data Base

  Journal of Surgical Oncology · 2016-07-08 · 13 citations

  article1st authorCorresponding

  BACKGROUNDS AND OBJECTIVES: Medullary breast carcinoma (MBC) is a subtype with a more favorable prognosis. Tumors with some, but not all, characteristics of MBC are classified as atypical medullary carcinoma of the breast (AMCB). METHODS: Patients with invasive MBC and AMCB reported to the National Cancer Data Base (NCDB) from 2004 to 2013 were compared for tumor characteristics and overall survival, using infiltrating ductal carcinoma (IDC) as a reference. RESULTS: Patients with MBC (n = 3,688), AMCB (n = 288), and IDC (n = 918,870) met inclusion criteria. Comparing MBC with AMCB, the mean age at diagnosis (52.9 vs. 53.9 years), mean tumor size (2.4 vs. 2.5 cm), lymph node positivity (22.8% vs. 22.4%), estrogen receptor (ER) positivity (22% vs. 25%), progesterone receptor (PR) positivity (14% vs. 15%), HER2 positivity (11% vs. 14%), rate of breast conserving surgery (67% vs. 68%), use of chemotherapy (76% vs. 75%), and use of hormonal therapy (19% vs. 18%), respectively, were not clinically or statistically different. Five-year (92% vs. 89%) and 10-year survival rates (85% vs. 87%) were not significantly different (P = 0.46). CONCLUSIONS: There does not appear to be any reason to differentiate between AMCB and MBC given the similarities in presentation, treatment and prognosis. J. Surg. Oncol. 2016;114:533-536. © 2016 Wiley Periodicals, Inc.

  PublisherDOI

Frequent coauthors

• Allison A. Aggon

  Fox Chase Cancer Center

  4 shared

• Anna M. Mazor

  Fox Chase Cancer Center

  4 shared

• Mark Sundermeyer

  4 shared

• J.M. Daly

  University of British Columbia

  4 shared

• Lyudmila DeMora

  NRG Oncology

  4 shared

• Richard J. Bleicher

  Fox Chase Cancer Center

  4 shared

• Elin R. Sigurdson

  Fox Chase Cancer Center

  4 shared

• V. Suzanne Klimberg

  The University of Texas Medical Branch at Galveston

  3 shared