Abstract B49: Factors affecting the treatment of young women with breast cancer at tertiary referral public and private hospitals

Abstract

Abstract Background: Disparities persist in receipt of treatment and outcomes of breast cancer patients with varying race, English proficiency, and socioeconomic backgrounds. This is confounded in young women (≤ 45 years old), as age becomes an additional factor. We sought to assess our surgical experience with young breast cancer patients, at a public safety-net hospital (BH) and a private cancer center (PCC) that are staffed by specialty trained providers from the same university. Methods: We reviewed demographic and clinical-pathologic data from 275 breast cancer patients with invasive breast cancer (Stage I-III) 45 years old and younger from the public and private hospital IRB-approved databases. There were 69 patients in the BH group and 206 patients in the PCC group. Demographic variables (race, education, and primary language), surgery type, method of presentation, and stage were analyzed using Pearson's chi-square tests and binary logistics. Results: At PC the patients were Caucasian (68%), Asian (11%), Hispanic (10%), and African American (8.7%). At BH patients were Spanish/Hispanic/Latino (47.8%), Asian (27.5%), and African American (10.1%). The majority of patients (82%) at PC had a college or graduate degree compared to 18.6% of the patients at BH (P<0.001). All the patients at PC reported English as their primary language compared to 30% of patients at BHC (P<0.001). There was a significant difference between the stages at which patients presented to either hospital (P = 0.042). At PC, most patients presented at Stage I (54.4%), while most presented at stage II at BH (42.0%). Additionally, a significantly higher number of patients at BHC (81.2%) than at PC (68.4%) presented with a palpable mass (P = 0.043). Hospital site was not a predictor of receipt of mastectomy (P = 0.502). Stage significantly affected the type of treatment received (P<0.01); patients with higher stage were more likely to receive a mastectomy. A patient's race, primary language, and education level at both hospitals did not increase the likelihood of receiving a mastectomy. A majority of the mastectomy patients at both institutions received immediate cosmetic reconstruction 87% (BH) vs. 76%(PCC). Conclusion: Young women with breast cancer treated at public hospital affiliated with an academic center had equivalent surgical treatment regardless of race, primary language, method or stage or presentation, and education level as young breast cancer patients treated at an academic private hospital. Citation Format: Ami Patel, Shubhada Dhage. Factors affecting the treatment of young women with breast cancer at tertiary referral public and private hospitals [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr B49.