Her2 positivity and race predict higher mastectomy rates: a SEER database analysis

Area of Science:

• Oncology
• Surgical Oncology
• Health Disparities

Background:

• Breast cancer incidence and treatment vary significantly by race.
• Disparities in surgical management between Black and White women with early-stage breast cancer are a concern.
• Molecular subtypes of breast cancer may influence surgical decisions.

Purpose of the Study:

• To investigate the association between breast cancer molecular subtypes and the choice between mastectomy and lumpectomy.
• To examine potential racial differences in surgical decision-making for early-stage breast cancer (T1 and T2 tumors).
• To explore the role of Her2 and hormone receptor (HR) status in surgical outcomes.

Main Methods:

• Analysis of the SEER database for women aged 15+ with T1 or T2 invasive breast cancer (2010-2012).
• Tumors categorized by molecular subtype (Her2, HR status) and stratified by tumor size and race.
• Bivariate comparisons and logistic regression models adjusted for age were employed.

Main Results:

• Mastectomy rates were higher for Her2-positive tumors compared to Her2-negative tumors.
• Women with HR-positive tumors were less likely to undergo mastectomy than those with HR-negative tumors, when Her2 status was similar.
• For T1 tumors, the association between subtype and surgical choice was more pronounced in White women.

Conclusions:

• Breast cancer subtype significantly influences surgical decisions (mastectomy vs. lumpectomy) in women with T1/T2 tumors.
• Race may play a role in surgical decision-making, particularly for T1 tumors.
• The strong link between Her2-positive status and mastectomy necessitates further research.