Hospitals Serving Primarily Minority Patients Likely to Offer Standard of Surgical Care for Breast Cancer

Results from a study presented at the virtual American College of Surgeons (ACS) Clinical Congress 2020 suggested that among accredited US cancer centers, hospitals which serve primarily minority patients are as likely as other hospitals to offer the standard of surgical care for early-stage breast cancer.

“There are a lot of health disparities in cancer: in access to care, treatment, and outcomes,” senior study investigator T. Salewa Oseni, MD, FACS, assistant professor of surgery at Harvard Medical School in Boston, said in a press release. “In our study, we were pleasantly surprised there was no difference between the care that black, Hispanic, and white women receive.”

In this study, researchers used data from the National Cancer Database to evaluate more than 21,000 patients with breast cancer treated in 2015 and 2016. Of note, this database includes information on more than 70% of newly diagnosed cancer cases in the US and is the largest database of its kind.

The researchers looked to determine whether the cancer centers omitted axillary lymph node dissection (ALND) in appropriately selected patients, which they defined as uptake of results from 3 landmark clinical trials. These studies were the ACS Oncology Group (ACOSOG) Z0011 trial published in 2011, the ACOSOG Z1071 trial in 2013, and the After Mapping of the Axilla: Radiotherapy or Surgery (AMAROS) trial by the European Organisation of Research and Treatment of Cancer in 2014.

Among 7167 patients who met the criteria for the ACOSOG Z0011 trial, there was a similar uptake of the recommendation to omit ALND between minority serving hospitals (MSH) and non-MSH (74.6% vs 72.9%, respectively). Similarly, uptake of the ACOSOG Z1071 results was comparable among the 4546 patients who met the study criteria (41.9% for MSH and 44.9% for non-MSH).

Moreover, among the 9433 patients who matched criteria for the AMAROS trial, uptake was slightly lower at MSH (11.7%) compared with 14% at non-MSH, according to the study abstract. However, after adjusting for multiple factors, no difference was found in uptake by MSH status.

In an interview with CancerNetwork®, Oseni along with lead study investigator Olga Kantor, MD, MS, an associate surgeon at Brigham and Women’s Hospital in Boston, discussed the study findings further and what the implications are for MSH.

This segment comes from the CancerNetwork® portion of the MJH Life Sciences Medical World News, airing daily on all MJH Life Sciences channels.

Reference:

Hospitals serving primarily minority patients follow breast cancer surgical recommendations at similar rate to other hospitals [news release]. Chicago. Published October 3, 2020. Accessed October 12, 2020.