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Generating a Murine Orthotopic Metastatic Breast Cancer Model and Performing Murine Radical Mastectomy
Published on: November 29, 2018
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Survival Disparities in Patients With Metastatic Breast Cancer
Koumani W Ntowe1, Samantha M Thomas2,3, Marguerite M Rooney1
1Department of Surgery, Duke University Medical Center, Durham, NC.
JCO Oncology Practice
|January 21, 2026
Summary
Racial and insurance disparities persist in de novo metastatic breast cancer (dnMBC) survival. Non-Hispanic Black and uninsured patients face significantly worse outcomes, highlighting the need for improved healthcare access and systemic change.
Area of Science:
- Oncology
- Health Services Research
- Epidemiology
Background:
- De novo metastatic breast cancer (dnMBC) has a typically fatal prognosis.
- Recent treatment advances have improved survival, but equitable benefit distribution is uncertain.
- Disparities in outcomes based on race/ethnicity and insurance status are a significant concern.
Purpose of the Study:
- To evaluate the association of race/ethnicity and insurance status with survival outcomes in patients with dnMBC.
- To identify specific racial/ethnic and insurance groups with poorer survival.
- To understand if survival improvements are reaching all dnMBC patient populations equally.
Main Methods:
- Analysis of 47,034 patients diagnosed with dnMBC between 1988 and 2016 from the SEER database.
- Stratification by race/ethnicity (NHW, NHB, NHO, Hispanic) and insurance status (private/Medicare, Medicaid, uninsured).
- Estimation of overall survival (OS) and cancer-specific survival using multivariable models for adjusted analyses.
Main Results:
- Non-Hispanic Black (NHB) patients and uninsured patients exhibited the worst median OS (21 and 22 months, respectively).
- After adjustment, NHB patients (HR 1.24) and uninsured patients (HR 1.29) had significantly worse OS compared to NHW and insured patients.
- While survival improved across all groups over time, persistent disparities were observed.
Conclusions:
- Significant racial/ethnic and insurance-related disparities in dnMBC survival persist.
- Non-Hispanic Black and uninsured individuals experience notably worse outcomes.
- Improving healthcare access and addressing systemic factors beyond insurance are crucial for achieving equitable survival for all dnMBC patients.
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