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Racial Differences in Utilization of Breast Conservation Surgery: Results from the National Cancer Data Base (NCDB)

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Whether rates of breast-conservation surgery (BCS) vary based on race and ethnicity has not been clearly elucidated on a national leve.

Methods

The National Cancer Data Base (NCDB) was used to identify women who underwent surgery for invasive breast cancer during 2010 and 2011. The effect of race and ethnicity on BCS rates was determined, independent of patient demographics, tumor-related variables, and geographic region.

Results

There were 299,827 patients with known race and ethnicity who underwent definitive breast surgery. BCS rates by race were as follows: 135,065/241,236 (56.0 %) for whites, 17,819/33,301 (53.5 %) for blacks, 4,722/9,508 (49.7 %) for Asian/Pacific Islanders, and 7,919/15,782 (50.2 %) for Hispanics (p < 0.001). Mean tumor size differed among the racial groups: 2.07 cm in whites, 2.54 cm in blacks, 2.23 cm in Asians, and 2.48 cm in Hispanics (p < 0.001). When stratified by tumor size, BCS was most common in blacks and least common in Asians for all tumors >2 cm (p < 0.001). On multivariable analysis adjusted for age, tumor size, nodal status, grade, molecular type, geographic area, urban/rural residence, insurance status, and census-derived median income and education for the patient’s zip code, the odds ratio for BCS for blacks compared to whites was 1.23 (95 % confidence interval [CI] 1.20–1.27, p < 0.001), for Asians was 0.84 (95 % CI 0.80–0.88, p < 0.001), and for Hispanics was 1.00 (95 % CI 0.96–1.05, p = 0.885).

Conclusions

When adjusted for patient demographics, tumor-related variables, and geographic area, BCS rates are higher in blacks and lower in Asians compared to whites.

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Disclosure

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Department of Surgery and Yale Comprehensive Cancer Center, Yale University School of Medicine, New Haven, CT, USA

    Princess Thomas MD, Brigid K. Killelea MD, MPH, Nina Horowitz MD, Anees B. Chagpar MD, MSc, MPH, MA, MBA & Donald R. Lannin MD

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  1. Princess Thomas MD
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  2. Brigid K. Killelea MD, MPH
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  3. Nina Horowitz MD
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  4. Anees B. Chagpar MD, MSc, MPH, MA, MBA
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  5. Donald R. Lannin MD
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Correspondence to Donald R. Lannin MD.

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Thomas, P., Killelea, B.K., Horowitz, N. et al. Racial Differences in Utilization of Breast Conservation Surgery: Results from the National Cancer Data Base (NCDB). Ann Surg Oncol 23, 3272–3283 (2016). https://doi.org/10.1245/s10434-016-5475-x

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  • DOI: https://doi.org/10.1245/s10434-016-5475-x

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