Identifying and Treating Those at Risk: Disparities in Rapid Relapse Among TNBC Patients in the National Cancer...

Area of Science:

• Oncology
• Public Health
• Health Services Research

Background:

• Triple-negative breast cancer (TNBC) is an aggressive subtype with a poor prognosis.
• Rapid relapse TNBC (rrTNBC) represents a particularly challenging subset requiring further characterization.
• Understanding factors influencing rrTNBC is crucial for improving patient outcomes.

Purpose of the Study:

• To characterize the features of rapid relapse TNBC (rrTNBC) using the National Cancer Database (NCDB).
• To identify demographic, tumor, and treatment-related factors associated with rrTNBC.
• To evaluate the impact of treatment receipt on the probability of rrTNBC.

Main Methods:

• Analysis of TNBC patients diagnosed between 2010-2019 in the NCDB.
• Definition of rrTNBC as all-cause mortality within 24 months of diagnosis.
• Utilized univariate, bivariate, and multiple logistic regression, including two-part models to assess treatment effects.

Main Results:

• Overall, 14.5% of TNBC patients experienced rapid relapse.
• Older age (>75), Black race, Medicare insurance, and higher comorbidity scores (Charlson-Deyo ≥2) were linked to lower odds of receiving both chemotherapy and breast surgery.
• Patients not receiving both treatments had a 2-3 fold higher probability of rrTNBC, particularly those over 75, with Medicare, or with high comorbidity scores.

Conclusions:

• Age, insurance status, and comorbidities influence treatment likelihood.
• Receiving both chemotherapy and breast surgery significantly reduced the risk of rrTNBC by threefold.
• Findings can inform clinical care delivery and research into treatment protocols for diverse TNBC populations.