Clinical, sociodemographic, and pathological characteristics of breast cancer in the United States: A cross-sectional analysis from the National Cancer Database (NCDB).

Abstract

e13623 Background: Breast cancer (BC) remains the most commonly-diagnosed malignancy in women. BC encompasses great heterogeneity in patient pathologic and clinical characteristics, as well as treatment approaches and outcome by stage and subtype. This study aims to explore recent differences in characteristics and overall survival (OS) of BC across different facility types. Methods: We conducted a retrospective analysis of patients with BC, diagnosed between 2004-2016, based on the NCDB. Categorical variables were summarized using frequencies/percentages, whereas continuous variables were summarized using the median/interquartile range (IQR). OS was explored using the Kaplan-Meier method. Results: A total of 2,671,549 patients with BC were captured in this dataset. The median age at diagnosis was 61 (range 18-90 years). The majority n = 1,986,450 (75%) were non-Hispanic (NH) white; 286,176 (11%) were NH-black; 124,877 (4.7%) were Hispanic-white; 2,977 (0.1%) were Hispanic-black and 90,484 (6.1%) were Asian. The most common BC subtype was hormone receptor-positive (HR+)/HER2- (58%), followed by HR+/HER2+ (26%), HR-/HER2-negative (10%) and HR-/HER2+ (6.4%). 73% of cases were ductal; 15% lobular; the remaining histological subtypes included 0.9% epithelial-myoepithelial, 0.1% fibroepithelial, 0.4% metaplastic, < 0.1% mesenchymal, 1.6% rare breast carcinomas and 7% other carcinomas. The majority of patients received therapy at comprehensive community cancer programs (CPs) (45%), followed by academic/research CPs (30%), integrated network CPs (15%) and community CPs (9.5%). OS was best at academic (72% 10-year OS), followed by integrated network (69% 10-year OS), comprehensive community (68% 10-year OS) and community (63% 10-year OS) CPs. Significant differences in OS according to facility type remained when stratified by stage of disease (all p < 0.0001). OS was also significantly better for white (69% 10-year OS) versus black (63% 10-year OS) patients. Conclusions: This large database from the NCDB provides a comprehensive, recent overview of BC over the last 12 years. Facility type appears to be significantly associated with OS, such that academically designated centers have superior OS across all stages.