A. T. Knisely2, J. H. Mehaffey1, A. D. Michaels1, D. R. Brenin1, A. T. Schroen1, S. Showalter1 1University Of Virginia,Department Of Surgery,Charlottesville, VA, USA 2University Of Virginia,School Of Medicine,Charlottesville, VA, USA
Introduction: It is not known what factors affect whether patients complete the prescribed neoadjuvant chemotherapy regimen in breast cancer. Racial and socioeconomic disparities have been demonstrated in breast cancer therapy. We hypothesized that race will be a predictor of completion of prescribed neoadjuvant chemotherapy regimen in patients with breast cancer.
Methods: Patients diagnosed with breast cancer between 2009 and 2016 treated with neoadjuvant chemotherapy (n=63) at a single institution were reviewed. Patient demographics, socioeconomic status, and tumor characteristics as well as treatment details were abstracted by chart review. Univariate analysis was used to compare variables by completion of neoadjuvant chemotherapy. Unadjusted logistic regression was performed to evaluate the effects of these factors on patient's chances of completing their prescribed chemotherapy regimen.
Results: In our study population, 76.2% (n=48) of the patients completed their prescribed neoadjuvant chemotherapy regimen. On univariate analysis, patients who completed their regimen were significantly more likely to be white (79.2% vs 46.7%, p=0.02). Rates of completion of neoadjuvant chemotherapy were not significantly different among patients with private vs government insurance, positive vs negative nodal status, pathologic complete response, age or tumor size (all p>0.05). Unadjusted logistic regression demonstrated white patients were 7 times more likely to complete neoadjuvant chemotherapy (OR 7.0, p=0.01). Tobacco use significantly reduced the odds of a patient completing neoadjuvant chemotherapy (OR 14.4, p=0.02).
Conclusion: In our patient population of breast cancer patients treated with neoadjuvant chemotherapy, white patients were more likely to complete the prescribed course of neoadjuvant therapy. Future work should evaluate the reason non-white patients are less likely to complete chemotherapy and further assess the racial disparities in breast cancer therapies.
