A. C. DuBose1, Q. D. Chu1 1Louisiana State University Health Sciences Center,Division Of Surgical Oncology, Department Of Surgery,Shreveport, LA, USA
Introduction: A recent study reported that racial/ethnic disparity in breast cancer mortality in the 50 largest cities in the U.S. has risen sharply, which can be attributed to a higher “amenability index”, a measure of accessibility to technologic advances. Our institution provides equal access and technologic advances to all women with breast cancer, irrespective of their socioeconomic status (SES). We determine whether such a practice can eliminate disparities in breast cancer outcome.
Methods: A prospective breast cancer database examined outcome for 977 patients with stage 0 to III breast cancer treated up to April 2013. The majority received standard definitive surgery as well as appropriate adjuvant treatment. Primary endpoint was overall-survival (OS). Statistical analysis performed included Kaplan-Meier survival analysis and independent-samples t test. P ≤ 0.05 was considered statistically significant.
Results: Sixty-one percent of patients were African-Americans (AA), and three-quarters were either free care or Medicaid. Despite having a more aggressive tumor subtype (a lower percentage of ER/PR-positivity in AA as compared to Caucasian (C) patients; 38% vs. 52%, respectively), the 5-year overall survival (OS) for AA and C patients was similar (84% vs. 87%, respectively; P = 0.23). Multivariate analysis confirmed that race/ethnicity was not an independent predictor of OS (P=0.14); OS for the entire cohort was comparable with that of the SEER database.
Conclusion: In a predominantly indigent population, equal access to care negates racial disparity in patients with breast cancer.
