Breast Cancer Presentation and Treatment Patterns in Sexual and Gender Minorities

Area of Science:

• Oncology
• Health Disparities
• Surgical Oncology

Background:

• Investigating disparities in breast cancer care for sexual and gender minority (SGM) patients compared to cisgender heterosexual women (CHW).
• Understanding differences in presentation, management, and outcomes is crucial for equitable cancer care.

Purpose of the Study:

• To compare breast cancer presentation, management, and outcomes between SGM patients and CHW.
• To identify potential disparities in surgical treatment and reconstructive options.

Main Methods:

• Prospective review of an institutional database for patients with stage 0-III breast cancer (2016-2023).
• Identification of SGM patients based on self-documented sexual orientation and gender identity.
• Descriptive statistics used for comparative analysis between SGM and CHW groups.

Main Results:

• No significant differences in presenting symptoms, stage, grade, or subtype between SGM and CHW.
• SGM patients were younger at diagnosis (p=0.03) and more likely to undergo mastectomy (p=0.04).
• SGM patients were less likely to have reconstruction after mastectomy (p<0.01), with similar rates of adjuvant therapy and recurrence.

Conclusions:

• Breast cancer presentation, treatment, and outcomes were comparable between SGM and CHW patients.
• SGM patients showed a lower utilization of breast conservation and post-mastectomy reconstruction.
• Patient preference, influenced by SGM identity, may impact local therapy choices.