O. Font-Torres1, S. Khedr1, J. Hong1, D. Abramov1, A. Raidah1, J. Zhang1, J. Lee1, D.S. Heffernan3, S.Y. Chao1,2, T. Ju1,2 1New York Presbyterian-Queen, General Surgery, Queens, NY, USA 2Weill Cornell Medicine, General Surgery, New York, NY, USA 3Brown University, General Surgery, Providence, RI, USA
Introduction: Numerous investigations have highlighted the limited representation of racial and ethnic diversity in clinical studies related to breast surgery conducted in the United States. This gap limits the ability to apply many study results in breast care to different patient populations. Our study aims to evaluate the current state and trends of race and ethnicity reporting in peer-reviewed breast surgery articles.
Methods: Pubmed search engine was queried for breast surgery related clinical research articles published from January 2017 to June 2023. The top 4 breast journals with the highest impact factors were evaluated: Annals of Surgical Oncology, Breast Cancer Research and Treatment, Clinical Breast Cancer, and The Breast Journal. Basic science, translational studies, and international studies were excluded. Statistical analyses were conducted using chi-square tests or ANOVA (GLM) with SAS Studio.
Results: 290 studies were included, with 179 (62%) reporting any race/ethnicity. Studies were divided based on year of publication into three study periods: 2017-2018 (n=109), 2019-2020 (n=86), 2021-2023 (n=95). The number of studies reporting race or ethnicity increased overall in all three time periods (47% in 2017-2018, 64% in 2019-2020, and 70% in 2021-2023) (p=0.05). Studies consistently reported White race across all time periods (100%) (p=0.10). Reporting of Black race (79% to 88%, p=0.23), Asian race (50% to 59%, p=0.31), Hispanic ethnicity (41% to 48%, p=0.73), and “Other” race (55% to 68%, p=0.33) did not significantly increase over all time periods. American Indian (11%) and Asian (6%) race were the least likely to be reported. Using Kruskal Wallis analysis, reporting of any race/ethnicity was found to have increased in later years (n=290, p=0.01). There was no increase in the number of studies reporting White race (p=0.77). The reporting of Black race increased in later years, but failed to reach significance (p=0.09). Reporting of Asian race (p=0.45) and Hispanic ethnicity did not change significantly over the years (p=0.61).
Conclusion: The reporting of racial diversity has increased in recent years in the field of breast surgery research. However, race and ethnicity reporting in articles published in high-impact breast journals has not changed significantly. Given the enhanced opportunities for individualizing breast cancer, it is essential that studies accurately report race and ethnicity. Furthermore, consistent representation of minority groups in the literature could help elucidate potential disparities affecting outcomes in these populations and allow wider applicability of study results, which should be the focus of future efforts.