Racial Disparities in Survival and Age-Related Outcome in Postsurgery Breast Cancer Patients in a New York City Community Hospital

Abstract

Breast cancer survival has significantly improved over the past two decades. However, the diagnosis of breast cancer is lower and the mortality rate remains higher, in African American women (AA) compared to Caucasian-American women. The purpose of this investigation is to analyze postoperative events that may affect breast cancer survival. This is a retrospective analysis of prospectively collected data from The Brooklyn Hospital Center cancer registry from 1997 to 2010. Of the 1538 patients in the registry, 1226 are AA and 269 are Caucasian. The study was divided into two time periods, 1997–2004 (period A) and 2005–2010 (period B), in order to assess the effect of treatment outcomes on survival. During period A, 5-year survival probabilities of 75.37%, 74.53%, and 78.70% were seen among all patients, AA women and Caucasian women, respectively. These probabilities increased to 87.62%, 87.15% and 89.99% in period B. Improved survival in AA women may be attributed to the use of adjuvant chemotherapy, radiation, and hormonal therapy. Improved survival in Caucasian patients was attributed to the use of radiation therapy, as well as earlier detection resulting in more favorable tumor grades and pathological stages.

Disease-free survival in patients with non-metastatic breast cancer

“…Some of the factors that can influence disease progression include: early diagnosis, staging, histological and biological tumor characteristics, age, ethnic and social factors, and more. [6][7][8] Early diagnosis associated with treatment could reduce the mortality of the disease. [8][9][10][11][12] Disease-free survival (DFS) is defined as the time between the beginning of the treatment and disease progression or death from any cause.…”

“…[6][7][8] Early diagnosis associated with treatment could reduce the mortality of the disease. [8][9][10][11][12] Disease-free survival (DFS) is defined as the time between the beginning of the treatment and disease progression or death from any cause. [13][14][15] Factors related to a shorter DFS include tumors larger than 2 cm, the presence of lymph node involvement and more advanced stages of the disease.…”

Cancer mortality disparities among New York City’s Upper Manhattan neighborhoods

“…Previous studies focusing on NYC have shown disparities by co-morbidities (Van Wye et al 2008), screening rates (Richards et al 2011), and treatment outcomes (Martindale et al 2014). These NYC studies, including studies of other US locations that focus on cancer mortality (Whitman et al 2011; Hirschman, Whitman, and Ansell 2007), have focused on disparities according to racial/ethnic differences.…”

Literature review of data-based models for identification of factors associated with racial disparities in breast cancer mortality

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