Clinical Report: Inequities in the Presentation of Disease and Treatment for dnMBC
Overview
This study highlights significant racial and ethnic disparities in the presentation and treatment initiation of de novo metastatic breast cancer (dnMBC) in the US. Black women are more likely to present with aggressive disease and experience delays in treatment compared to White women, impacting survival outcomes.
Background
Breast cancer is the most prevalent cancer among women in the US and a leading cause of cancer-related mortality. De novo metastatic breast cancer, though accounting for a small percentage of cases, disproportionately contributes to mortality. Understanding the disparities in disease presentation and treatment initiation is crucial for improving outcomes in affected populations.
Data Highlights
This study analyzed data from the National Cancer Database, focusing on patients diagnosed with dnMBC from 2010 to 2022.
Key Findings
Black women are more likely to present with dnMBC compared to White women, even after adjusting for socioeconomic factors.
Black women frequently present with more aggressive subtypes, such as triple-negative breast cancer (TNBC).
Disparities exist in the receipt of first-line treatments, with Black and Hispanic women less likely to receive CDK4/6 inhibitors and endocrine therapy.
Delays in treatment initiation are more common among Black women and those with Medicaid or uninsured status, correlating with worse survival outcomes.
26.8% of patients with metastatic breast cancer waited over 60 days to start treatment, often comprising younger and historically marginalized groups.
Clinical Implications
Healthcare providers should be aware of the disparities in disease presentation and treatment initiation among different racial and ethnic groups. Addressing these inequities is essential for improving survival outcomes in patients with dnMBC.
Conclusion
The findings underscore the urgent need to address racial and ethnic disparities in breast cancer care to enhance treatment equity and improve survival rates.
