Racial disparities in treatment and outcomes between non-Hispanic Black and non-Hispanic White women with nonmetastatic inflammatory breast cancer

• Published in: Breast cancer research and treatment Vol. 201; no. 2; pp. 275 - 287
• Main Authors: Carbajal-Ochoa, Walter H., Johnson, Devin, Alvarez, Alvaro, Bernal, Ana M., Anampa, Jesus D.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.09.2023; Springer; Springer Nature B.V
• Subjects: Analysis; Black or African American; Breast cancer; Breast Neoplasms - pathology; Cancer; Cancer research; Cancer therapies; Chemotherapy; Death; Demography; Epidemiology; Female; Health aspects; Hispanic American women; Hispanic people; Humans; Inflammation; Inflammatory Breast Neoplasms - epidemiology; Inflammatory Breast Neoplasms - therapy; Medicine; Medicine & Public Health; Oncology; Radiation; Radiation therapy; Radiotherapy; Risk assessment; Socioeconomic factors; Surgery; Survival; Treatment Outcome; White People; White women; Inflammatory breast cancer; Breast cancer; Socioeconomic status; Racial disparities
• ISSN: 0167-6806; 1573-7217
• DOI: 10.1007/s10549-023-07018-7

Purpose The incidence rate of inflammatory breast cancer (IBC) is higher among non-Hispanic Black (NHB) than non-Hispanic White (NHW) women. We examined the differences in treatment and outcomes between NHB and NHW women with IBC, accounting for demographic, clinicopathological, and socioeconomic factors. Methods We collected data from the Surveillance, Epidemiology, and End Results database for NHB and NHW women with IBC diagnosed between 2010–2016. We analyzed the odds of receiving chemotherapy, radiation, and surgery between NHB and NHW women. We evaluated overall survival (OS) with Kaplan–Meier methods and Cox proportional hazards methods. Competing risk analysis was used to compare the risk of breast cancer death between NHB and NHW women. We also evaluated the magnitude of survival disparities within the strata of demographic, socioeconomic, and treatment factors. Results Among 1,652 NHW and 371 NHB women with IBC, the odds of receiving chemotherapy, surgery, and radiation were similar for NHB and NHW. After 39-month follow-up, the median OS was 40 and 81 months for NHB and NHW, respectively ( p  < 0.0001). The risk of breast cancer death was higher for NHB than NHW women (5-year risk of breast cancer death, 51% vs. 35%, p  < 0.0001). Conclusion After adjustment for demographic, clinicopathological, and socioeconomic factors; NHB women with IBC had similar odds of receiving surgery, chemotherapy, and radiation therapy, but were more likely to die of the disease compared to their NHW counterparts. Our findings suggest the presence of masked tumor biology, treatment, or socioeconomic factors associated with race that can lead to worse IBC outcomes.