Disparities in Palliative Care Utilization in Metastatic Triple-negative Breast Cancer: A National Cancer Database...

Area of Science:

• Oncology
• Palliative Care
• Health Services Research

Background:

• Metastatic triple-negative breast cancer (TNBC) has an aggressive clinical course and poor prognosis.
• Real-world palliative care (PC) utilization patterns in metastatic TNBC are not well understood.
• Understanding factors influencing PC access is crucial for improving care in this population.

Purpose of the Study:

• To examine sociodemographic, policy, and facility-level factors associated with PC utilization in metastatic TNBC.
• To identify disparities in PC access among patients with metastatic TNBC.

Main Methods:

• Analysis of adult patients with metastatic TNBC (2018-2023) from the National Cancer Database.
• PC defined as non-curative intent surgery, radiation, systemic therapy, pain management, or combinations.
• Multivariable logistic regression used to evaluate factors associated with PC utilization.

Main Results:

• Only 19.5% (1,798/9,211) of metastatic TNBC patients received PC.
• Medicaid expansion, being uninsured, and treatment at academic/research programs were linked to higher PC utilization.
• Significant geographic variations in PC utilization were observed across US regions.

Conclusions:

• PC utilization is low and unequally distributed among patients with metastatic TNBC.
• Insurance coverage, facility type, and geographic region significantly impact PC access.
• There is a critical need for equitable and timely integration of PC for metastatic TNBC patients.