Abstract
Purpose
Breast cancer (BC) survival favors White versus Black Americans despite advances in
screening and treatment. We hypothesized that these differences were dependent upon
quality of care by analyzing long-term outcomes of 3139 early BC patients at our quaternary
care center where uniform access and management of BC is provided to women irrespective
of race.
Methods
Prospectively collected data for clinical stage I-II BC patients from our quaternary
care cancer center were analyzed, focusing on disease-specific survival (DSS). Subgroup
analyses included the overall cohort, triple-negative BC (TNBC), non-TNBC and HER2/neu
positive patients. Multivariable analyses to evaluate associations of variables with
DSS were performed for each subgroup.
Results
The overall cohort consisted of 3139 BC patients (1159 Black, 1980 White). Black and
White patients did not differ by most baseline variables. Black patients had higher
rates of TNBC (18% versus 10%, p < 0.0001). Kaplan-Meier analysis of all subgroups
(overall, TNBC, non-TNBC, HER2/neu positive) did not reveal DSS differences between
Black and White patients. Multivariable analysis of subgroups also did not find race
to be associated with DSS.
Conclusion
In this large, carefully controlled, long term, single-institution prospective cohort
study DSS in Black and White early BC patients with equal access to high quality care,
did not differ. While BC patients with adverse molecular markers did slightly worse
than those with more favorable markers, there is no observable difference between
Black and White women with the same markers. These observations support the conclusion
that equal access to, and quality, of BC care abolishes racial disparities in DSS.
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Article info
Publication history
Published online: November 28, 2022
Accepted:
November 20,
2022
Received in revised form:
November 20,
2022
Received:
October 10,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
