Differences in Survival and Associated Characteristics Between Asian American and White Patients With Breast Cancer

Extensive research has explored racial differences in breast cancer survival, particularly between Black and White patients. However, few studies have included comparisons with Asian American and White populations.

We conducted a retrospective cohort study using data from the SEER database (2010-2021) for Asian American and White patients with breast cancer. Propensity score matching (PSM) was applied to balance baseline characteristics including age, stage, molecular subtype, and treatment. Survival analyses included Kaplan-Meier (KM) curves, Cox proportional hazards models, and subgroup analyses. Outcomes were overall survival (OS) and breast cancer-specific survival (BCSS).

This study included 374,930 patients with breast cancer, with 44,092 Asian American patients with breast cancer and 330,838 White patients with breast cancer. After PSM balanced baseline characteristics, Asian American patients with breast cancer showed significantly better OS (HR = 0.78, 95% CI, 0.75-0.81) and BCSS (HR = 0.88, 95% CI, 0.84-0.93) than White patients with breast cancer. Consistent survival advantages were observed across all clinical and demographic subgroups. After adjustment for key prognostic factors including stage, age, and treatment, Asian American patients with breast cancer remained independently associated with significantly improved survival (OS, HR = 0.77; BCSS, HR = 0.86).

Asian American patients with breast cancer demonstrated significantly better survival than White patients with breast cancer after adjusting for multiple factors, with a consistent advantage across subgroups. This suggests intrinsic biological or lifestyle protective factors, warranting further investigation.