Association of English language proficiency and breast cancer oncologic outcomes

Few studies have compared oncologic outcomes directly between English-speaking (ES) and non-English-speaking (NES) patients. We performed a matched cohort study of stage I-III breast cancer patients with ES patients propensity matched 3:1 to NES patients based on age, tumor stage, nodal involvement, and receipt of adjuvant therapy. Patients were categorized as ES or NES according to preferred language documented in the electronic medical record. Primary outcomes were locoregional recurrence (LRR), disease-free survival (DFS), and overall survival (OS). Among 2768 patients (2076 ES; 692 NES), median age at diagnosis was 62 years (range = 25-94). Ten-year LRR was 9.5% vs 13% (P = .032), 10-year DFS was 71% vs 63% (P = .008), and 10-year OS was 79% vs 74% (P = .12) for ES and NES patients, respectively. These findings suggest that NES patients may have inferior breast cancer outcomes, even in highly resourced academic environments. These findings highlight the need for targeted interventions beyond language assistance.