Conference Abstracts - Summit on Cancer Health Disparities (SCHD25)
Vol. 5, Issue Supplement 1, 2025 · S1-1
Comparison of the Factors Among De Novo Breast Cancer Patients That Impact Care Decision-Making
Andrea Curry, PhD, MHA,Yoriann Hull, BS,Gene Lamanilao, MD, MS,Fawaz Mzayek, MD, MPH, PhD,Janeane Anderson, PhD, MPH,Gregory Vidal, MD, PhD
Submission received: 2025-02-10 / Accepted: 2025-02-14 / Published: 2025-04-24
Abstract
Background
From 2018 to 2021, the number of Black patients with breast cancer (BC) who presented to the West Cancer Center and Research Institute in Germantown, TN, with de novo metastatic (DNM) disease significantly exceeded White patients. This study examined histologic patient profiles to evaluate factors that impact medical treatment-seeking.
Methods
We conducted a retrospective analysis to evaluate and compare the differences in prognosis, based on histological profiles (i.e., triple positive with triple negative receptors ER, PR, and HER2), in Black and White patients with DNM-BC. Survival analysis was performed using the Kaplan-Meier method to examine the association of tumor histology with survival from diagnosis. Cox proportional hazard regression was used to test the same association after adjusting for age, race, health insurance, marital status, employment status, education level, and time from 1st symptom to diagnosis.
Results
A total of 171 patients were included in the study (55.6% Black). The less-favorable histologic profile (triple negative) was 2.4 times more frequent in Black patients (p=0.04). Tumor histological profile was associated with prognosis, where the triple negative profile was associated with twice the hazard of death compared to the (triple positive) profile (HR = 2.1; 95% CI: 1.00, 4.41). In the fully adjusted model, race, educational level, and tumor histology were independently associated with the survival of patients with DNM-BC.
Conclusion
Black patients with DNM-BC have a worse prognosis compared to White patients. This racial disparity in the outcome is independent of tumor histological profile and educational level. Findings from this retrospective analysis provide opportunities for future research that examines perspectives from patients and healthcare clinicians about biological and psychosocial factors that contributed to delayed care among Black women with symptoms of DNM BC.