Racial, ethnic and socioeconomic disparities in diagnosis, treatment, and survival of patients with breast cancer

Background: The objective of this study was to determine the influence of race/ethnicity and socioeconomic status (SES) on breast cancer outcomes. Methods: A retrospective analysis was performed of Non-Hispanic Black (NHB), Non-Hispanic White (NHW), and Hispanic patients with non-metastatic breast cancer in the SEER cancer registry between 2007 and 2016. Results: A total of 382,975 patients were identified. On multivariate analysis, NHB (OR 1.18, 95%CI: 1.15-1.20) and Hispanic (OR 1.20, 95%CI: 1.17-1.22) patients were more likely to present with higher stage disease than NHW patients. There was an increased likelihood of not undergoing breast-reconstruction for NHB (OR 1.07, 95%CI: 1.03-1.11) and Hispanic patients (OR 1.60, 95%CI 1.54-1.66). NHB patients had increased hazard for all-cause mortality (HR: 1.13, 95%CI 1.10-1.16). All-cause mortality increased across SES categories (lower SES: HR 1.33, 95%CI 1.30-1.37, middle SES: HR 1.20, 95%CI 1.17-1.23). Conclusions: This population-based analysis confirms worse disease presentation, access to surgical therapy, and survival across racial, ethnic, and socioeconomic factors. These disparities were compounded across worsening SES and insurance coverage.

Automated summary

The objective of this study was to investigate the impact of race/ethnicity and socioeconomic status on breast cancer outcomes. The results showed that Non-Hispanic Black and Hispanic patients were more likely to present with advanced stage disease compared to Non-Hispanic White patients. Additionally, Non-Hispanic Black and Hispanic patients were less likely to undergo breast-reconstruction. Furthermore, Non-Hispanic Black patients had increased hazard for all-cause mortality, and all-cause mortality increased with worsening socioeconomic status.