Racial, ethnic and socioeconomic disparities in diagnosis, treatment, and survival of patients with breast cancer- A Population Analysis in the United States

Racial disparities in breast cancer are well established. However, there is a paucity of literature assessing the interaction of patient, socioeconomic, and community factors on breast cancer care. The objective of this study was to determine the influence of race/ ethnicity, socioeconomic status (SES), and insurance status on disease presentation, access to care, and survival in breast cancer. A retrospective analysis was conducted of patients of Non-Hispanic White (NHW), Hispanic, and Non-Hispanic Black (NHB) patients with non-metastatic breast cancer in a large American national cancer registry. A total of 382,975 patients were identified. We demonstrated that NHB and Hispanic patients are more likely to present with more advanced stage disease, less likely to undergo surgery, and less likely to undergo breast reconstruction than their NHW counterparts. We also demonstrated worse survival for NHB patients compared to NHW patients. Furthermore, we demonstrated that these disparities were compounded across worsening socioeconomic status and insurance coverage.