Racial Disparities in the Incidence, Breast Conserving Rate and Survival of Breast Cancer Patients Who Underwent Breast Conserving Surgery

Objective: In the current study, we aimed to provide a clear insight on the racial disparity of breast conserving rate (BCR) and survival in breast cancer after breast conserving surgery (BCS). Materials and Methods: Using data from the Surveillance, Epidemiology, and End Results program (SEER), we estimated breast cancer incidence rates and the rate of BCS by race in two periods (2000-2004 and 2013-2017). Relative survival analysis was based on patient-level data from 1998 to 2017. To be adjusted for baseline differences for different races, inverse probability weighting (IPW) models were stepwise performed.Results: From 2000-2004 to 2013-2017, both the breast cancer incidence (from 4.18 to 5.05 per 1000 white women) and the proportion of patients after BCS (from 55.5% to 59.9) were highest in whites than that of other races. Black individuals’ incidence (1.20 per 1000 black women or relatives 43.6% increased) and the BCR were increased most rapidly (6%) than other races. Asian or Pacific Islanders (APIs) were less likely to be diagnosed at a later stage and had the best prognosis than those of other races. After baselines fully adjusted, whites had the better Breast Cancer Specific Survival (BCSS) and Overall Survival (OS) than that of minorities (all p< 0.001).Conclusions: We identified the racial disparities of breast cancer incidence, BCR, and survival differences. We found increase trends of breast cancer incidence and BCR in minorities; however, we also identified the worse survival of minorities than that of whites, regardless of age, tumor stage, grade, and Luminal subtype.