E. C. Feliberti1, R. R. Perry1, R. C. Britt1, J. C. Collins1, E. Feliberti1 1Eastern Virginia Medical School,Surgery,Norfolk, VA, USA
Introduction: Safety net programs aim to minimize disparities in the treatment of breast cancer patients. We hypothesize that differences in the use of breast conservation therapy (BCT) persist in uninsured women despite access to a multidisciplinary clinic.
Methods: A retrospective review of a prospective database was performed on consecutive newly diagnosed female breast cancer patients treated at an academic surgical department form 2001 to 2015. Patients were stratified by insurance status at time of breast cancer diagnosis.
Results: A total of 523 patients were identified meeting the inclusion criteria, 85 without and 438 with medical insurance. The uninsured cohort were younger (mean age: 46.8 vs 58.1, p<0.01) and had a higher proportion of African-American women (68.7% vs 40.4%, p<0.01). Tumor size was similar between the 2 groups (Mean size 2.2 cm vs. 2.0, p=0.8). BCT was selected less often in the uninsured cohort (50.6% vs 64.6%, p=0.02). Differences in the use of BCT in the uninsured were significant in women aged 50 and older (42.*5 vs 68.4%, p<0.01) and for tumors larger than 2 cm (30% vs 54.4%, p<0.01).
Conclusion: Insurance status affects choice of surgical therapy in newly diagnosed breast cancer patients despite access to a safety net program. Increasing tumor size and age play a significant role in the decreased use of BCT.