Clinical Scorecard: Inequities in the Presentation of Disease and the Start of Treatment for De Novo Metastatic Breast Cancer

At a Glance

Key Highlights

• Black women are more likely to present with dnMBC and aggressive subtypes like triple-negative breast cancer (TNBC).
• Significant disparities exist in treatment receipt, with Black and Hispanic women less likely to receive recommended therapies.
• 26.8% of patients with metastatic breast cancer waited over 60 days to initiate treatment, often linked to socioeconomic factors.

Guideline-Based Recommendations

Diagnosis

• Utilize the National Cancer Database for comprehensive data on dnMBC presentation.

Management

• First-line treatment for HR-positive–ERBB2-negative dnMBC includes endocrine therapy plus CDK4/6 inhibitors.
• For ERBB2-positive dnMBC, consider dual HER2 blockade with trastuzumab and pertuzumab.

Monitoring & Follow-up

• Monitor treatment initiation times and outcomes across different racial and ethnic groups.

Risks

• Delays in treatment initiation are associated with worse survival outcomes.

Patient & Prescribing Data

Patients diagnosed with dnMBC from 2010 to 2022, with a focus on racial and ethnic disparities.

Black patients have lower rates of receiving targeted therapies and immunotherapy compared to White patients.

Clinical Best Practices

• Address inequities in treatment initiation to improve survival outcomes.
• Ensure equitable access to immunotherapy for metastatic TNBC.
• Implement community outreach programs to educate and facilitate access to treatment for marginalized groups.

References

• National Cancer Database
• Strengthening the Reporting of Observational Studies in Epidemiology (STROBE)