Breast Cancer Research and Treatment

, Volume 139, Issue 2, pp 561–569

Racial disparities in clinical presentation, surgical treatment and in-hospital outcomes of women with breast cancer: analysis of nationwide inpatient sample database

Epidemiology

DOI: 10.1007/s10549-013-2567-1

Cite this article as:
Dehal, A., Abbas, A. & Johna, S. Breast Cancer Res Treat (2013) 139: 561. doi:10.1007/s10549-013-2567-1

Abstract

To examine racial/ethnic disparities in stage of disease and comorbidity (pre-treatment), surgical treatment allocation (breast-conserving surgery versus mastectomy), and in-hospital outcomes after surgery (post-treatment) among women with breast cancer. Nationwide inpatient sample is a nationwide clinical and administrative database compiled from 44 states representing 95 % of all hospital discharges in the Unites States. Discharges of adult women who underwent surgery for breast cancer from 2005 to 2009 were identified. Information about patients and hospitals characteristics was obtained. Multivariate logistic regression analyses were used to examine the risk adjusted association between race/ethnicity and the aforementioned outcomes (pre-treatment, treatment, and post-treatment). We identified 75,100 patient discharges. Compared to Whites, African-Americans (1.17, p < 0.001), and Hispanics (1.20, p < 0.001) were more likely to present with regional or metastatic disease. Similarly, African-American (1.58, p < 0.001) and Hispanics (1.11, p 0.003) were more likely to have comorbidity. Compared to Whites, African-Americans (0.71, p < 0.001), and Hispanics (0.77, p < 0.001) were less likely to receive mastectomy. Compared to Whites, African-Americans were more likely to develop post-operative complications (1.35, p < 0.001) and in-hospital mortality (1.87, p 0.13). Other racial groups showed no statistically significant difference compared to Whites. After controlling for potential confounders, we found racial/ethnic disparities in stage, comorbidity, surgical treatment allocation, and in-hospital outcomes among women with breast cancer. Future researches should examine the underlying factors of these disparities.

Keywords

Racial disparity Surgical treatment In-hospital outcomes Breast cancer 

Supplementary material

10549_2013_2567_MOESM1_ESM.doc (43 kb)
Supplementary material 1 (DOC 43 kb)
10549_2013_2567_MOESM2_ESM.docx (11 kb)
Supplementary material 2 (DOCX 11 kb)

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Arrowhead Regional Medical CenterColtonUSA
  2. 2.University of Florida GainesvilleUSA
  3. 3.Tulane University Health Science CenterNew OrleansUSA
  4. 4.Kaiser PermanenteFontanaUSA