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Uptake of Breast Cancer Clinical Trials at Minority Serving Cancer Centers

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

Abstract

Background

Most minorities receive cancer care at minority-serving hospitals (MSHs) that have been associated with disparate treatment between Black and White patients.

Objective

Our aim was to examine the uptake of clinical trials that have changed axillary management in breast cancer patients at MSH and non-MSH cancer centers.

Methods

The National Cancer Database was used to identify patients eligible for the American College of Surgeons Oncology Group Z0011 and Z1071 trials, and mastectomy patients fulfilling the European AMAROS trial. Uptake of trial results (omission of axillary lymph node dissection) was analyzed between patients treated at MSHs and non-MSHs and adjusted for patient, tumor, and facility factors. MSHs were defined as the top decile of hospitals according to the proportion of Black and Hispanic patients treated.

Results

Of 7167 patients eligible for Z0011, 4546 for Z0171, and 9433 for AMAROS from 2015 to 2016, clinical trial uptake was seen in 1195 (74.6%) MSH and 4056 (72.9%) non-MSH patients (p = 0.173) for Z0011, 588 (41.9%) MSH and 1366 (43.5%) non-MSH patients for Z1071 (p = 0.302), and 272 (11.7%) MSH and 996 (14.0%) non-MSH patients (p = 0.005) for AMAROS. On adjusted analyses, MSH status was not significant for uptake of any of the three trials. Black race, socioeconomic status, and insurance were not associated with clinical trial uptake.

Conclusion

The uptake of three landmark clinical trials of axillary management in breast cancer was not different at MSH and non-MSH centers despite adjustment for social determinants of health. At the Commission on Cancer-accredited centers in this analysis, MSH status did not affect the uptake of evidence-based care.

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Author information

Authors and Affiliations

  1. Department of Surgery, Massachusetts General Hospital, Boston, MA, USA

    Olga Kantor MD, MS & Tawakalitu Oseni MD, FACS

  2. Department of Surgery, Brigham and Women’s Hospital, Boston, MA, USA

    Olga Kantor MD, MS & Anna Weiss MD

  3. Breast Oncology Program, Dana-Farber Cancer Institute, Boston, MA, USA

    Olga Kantor MD, MS & Anna Weiss MD

  4. Research Institute, NorthShore University HealthSystem, Evanston, IL, USA

    Cecilia Chang MS

  5. Department of Surgery, NorthShore University HealthSystem, Evanston, IL, USA

    Katharine Yao MD, FACS

  6. American College of Surgeons Cancer Programs, Chicago, IL, USA

    Katharine Yao MD, FACS, Judy Boughey MD, FACS, Christina Roland MD, FACS, Amanda B. Francescatti MS, Sarah Blair MD, FACS, Diana Dickson Witmer MD, FACS, Kelly K. Hunt MD, FACS, Heidi Nelson MD, FACS & Anna Weiss MD

  7. Department of Surgery, Mayo Clinic, Rochester, MN, USA

    Judy Boughey MD, FACS & Heidi Nelson MD, FACS

  8. Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Christina Roland MD, FACS & Kelly K. Hunt MD, FACS

  9. Department of Surgery, University of San Diego, San Diego, CA, USA

    Sarah Blair MD, FACS

  10. Department of Surgery, Helen F Graham Cancer Center and Research Institute, Newark, DE, USA

    Diana Dickson Witmer MD, FACS

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  1. Olga Kantor MD, MS
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Correspondence to Tawakalitu Oseni MD, FACS.

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Disclosures

Olga Kantor, Cecilia Chang, Katharine Yao, Judy Boughey, Christina Roland, Amanda B. Francescatti, Sarah Blair, Diana Dickson Witmer, Kelly K. Hunt, Heidi Nelson, Anna Weiss, and Tawakalitu Oseni have no relevant financial disclosures to declare.

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Kantor, O., Chang, C., Yao, K. et al. Uptake of Breast Cancer Clinical Trials at Minority Serving Cancer Centers. Ann Surg Oncol 28, 4995–5004 (2021). https://doi.org/10.1245/s10434-020-09533-z

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