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Socioeconomic Disparities in Neoadjuvant Chemotherapy for Early-Stage Breast Cancer
Yannis Reissis1, Luke Wolfe1, Tahia Karim1
1Department of Surgery, Massey Cancer Center, Virginia Commonwealth University Health System, Richmond, VA, USA.
Background:
Neoadjuvant chemotherapy (NCT) is often used for patients with early-stage breast cancer. Disparities in the use of NCT based on clinical, demographic, and socioeconomic factors have not been evaluated.
Methods:
Data from the National Cancer Database was analyzed for patients with T1-2, N0-1 breast cancer from 2006 to 2015. Univariate and multivariate analysis determined which factors predicted for the receipt of NCT.
Results:
We found 159 946 eligible patients. Factors associated with receipt of NCT included T2 vs. T1 disease, N1 vs. N0, and treatment at an academic facility. Race itself was not significant; however, a higher level of education amongst Black populations correlated with the receipt of NCT.
Discussion:
Clinical factors are the greatest determinants for receipt of NCT in early-stage breast cancer. Disparities exist that cannot be explained by race alone; socioeconomic and demographic factors are important. Cancer care should be evaluated in the context of the intersectionality of these health determinants.
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