Are We Overtreating Patients With T1a HER2+ Breast Cancer? An Analysis of the National Cancer Database

Williams, Austin D.; Solis, Odette; Sterbling, Hélène M.; Murray, Allison K.; Sogunro, Olutayo; Cruz, Lucy M. De La

doi:10.1016/j.clbc.2022.07.013

Cited by 2 publications

(1 citation statement)

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“…However, Black women were more likely to receive chemotherapy than White women, with the most notable discrepancies in receipt of chemotherapy among patients with a discretionary indication for chemotherapy [ 5 ]. Previous studies have suggested that Black women are more likely to receive chemotherapy than other racial and ethnic groups, which may lead to overtreatment among Black women expected to have a favorable prognosis [ 12 , 13 ]. In instances when chemotherapy is considered discretionary, Black women may be more likely to receive therapy due to the concern that their outcomes ( i.e., recurrence or mortality) are often worse than other racial and ethnic groups.…”

Section: Introductionmentioning

confidence: 99%

Racial disparities in initiation of chemotherapy among breast cancer patients with discretionary treatment indication in the state of Georgia

Collin,

Jones,

Nash

et al. 2024

Breast Cancer Res Treat

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Purpose The majority of breast cancer patients are diagnosed with early-stage estrogen receptor (ER) positive disease. Despite effective treatments for these cancers, Black women have higher mortality than White women. We investigated demographic and clinical factors associated with receipt of chemotherapy among those with a discretionary indication who are at risk for overtreatment. Methods Using Georgia Cancer Registry data, we identified females diagnosed with ER positive breast cancer who had a discretionary indication for chemotherapy (2010–2017). We used logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) associating patient demographic and clinical characteristics with chemotherapy initiation overall, and comparing non-Hispanic Black (NHB) with non-Hispanic White (NHW) women within strata of patient factors. Results We identified 11,993 ER positive breast cancer patients with a discretionary indication for chemotherapy. NHB patients were more likely to initiate chemotherapy compared with NHW women (OR = 1.41, 95% CI: 1.28, 1.56). Race differences in chemotherapy initiation were pronounced among those who did not receive Oncotype DX testing (OR = 1.47, 95% CI: 1.31, 1.65) and among those residing in high socioeconomic status neighborhoods (OR = 2.48, 95% CI: 1.70, 3.61). However, we observed equitable chemotherapy receipt among patients who received Oncotype DX testing (OR = 0.90, 95% CI: 0.71, 1.14), were diagnosed with grade 1 disease (OR = 1.00, 95% CI: 0.74, 1.37), and those resided in rural areas (OR = 1.01, 95% CI: 0.76, 1.36). Conclusion We observed racial disparities in the initiation of chemotherapy overall and by sociodemographic and clinical factors, and more equitable outcomes when clinical guidelines were followed.

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Section: Introductionmentioning

confidence: 99%