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Hispanic Ethnicity and Breast Cancer: Disaggregating Surgical Management and Mortality by Race

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Journal of Racial and Ethnic Health Disparities Aims and scope Submit manuscript

Abstract

Objective

Breast cancer is the leading cause of cancer death among Hispanic women. Unfortunately, few studies disaggregate Hispanic patients by race to understand its implications on treatment and clinical outcomes such as mortality. The aim of this study is to examine surgical management and overall mortality among different subgroups of women who self-identify as Hispanic.

Methods

Hispanic female patients, ages 18–90, stages I–III, diagnosed with breast cancer between 2010 and 2015 from the National Cancer Data Base were identified. The study cohort was divided into three ethnoracial categories: (1) Hispanic White (HW), 2) Hispanic Black (HB), and 3) Hispanic Other (HO). Descriptive statistics and multivariate models were constructed to determine the relationship between sociodemographic factors, clinical variables, surgical management, and mortality when disaggregated by race.

Results

There were 56,675 Hispanic women who met the study criteria. Most where HW (n=50,599, 89.3%) and the rest were HB (n=1,334, 2.4%) and HO (n=4,742, 8.3%). There was no difference between the three groups on receipt of breast conservation therapy (P=0.12). HB (48.5%) and HO (46.6%) women were more likely to undergo reconstruction than those who identified as HW (38.7%) (P<0.001). Additionally, HB (38.3%) women were more likely to undergo tissue-based reconstruction than HW (29.0%) and HO women (30%) (P=0.0008). There was no difference between the groups in the utilization of contralateral prophylactic mastectomy (CPM) (P=0.078). On multivariable analysis, there was no difference in mortality between HB and HW patients (HR 1.18, 95%CI 0.92–1.51; Ref HW). However, HO women had a 24% relative risk reduction in mortality (HR 0.76, 95% CI 0.63–0.92; HW ref).

Conclusion

Findings from this study suggest there are ethnoracial disparities in reconstruction utilization and mortality among Hispanic women. Future studies should examine how culture, language, healthcare access, and patient preferences contribute to these disparities.

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Data Availability

The data that support the findings of this study are available from the American College of Surgeons and the American Cancer Society, but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are however available from the authors upon reasonable request and with permission of the American College of Surgeons and the American Cancer Society.

The National Cancer Database (NCDB) is a joint project of the Commission on Cancer (CoC) of the American College of Surgeons and the American Cancer Society. The CoC 's NCDB and the hospitals participating in the CoC’s NCDB are the source of the de-identified data used herein; they have not verified and are not responsible for the statistical validity of the data analysis or the conclusions derived by the authors

Code Availability

Not applicable.

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Funding

Samilia Obeng-Gyasi is funded by the Paul Calabresi Career Development Award (K12 CA133250).

Author information

Authors and Affiliations

  1. Division of Surgical Oncology, Department of Surgery, The Ohio State University, Columbus, OH, USA

    Ahmad Hamad, Yaming Li, Allan Tsung, Bridget Oppong, Mariam F. Eskander & Samilia Obeng-Gyasi

  2. Department of Economics, Indiana University Purdue University, Indianapolis, IN, USA

    Oindrila Bhattacharyya

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  1. Ahmad Hamad
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Contributions

Conception or design of the work: Ahamd Hamad, Yaming Li, Allan Tsung, Bridget Oppong, Mariam Eskander, Oindrila Bhattacharyya, and Samilia Obeng-Gyasi.

Data collection: Ahamd Hamad, Yaming Li, Allan Tsung, Bridget Oppong, Mariam Eskander, Oindrila Bhattacharyya, and Samilia Obeng-Gyasi.

Data analysis and interpretation: Ahamd Hamad, Yaming Li, Allan Tsung, Bridget Oppong, Mariam Eskander, Oindrila Bhattacharyya, and Samilia Obeng-Gyasi.

Drafting the article: Ahamd Hamad, Yaming Li, Allan Tsung, Bridget Oppong, Mariam Eskander, Oindrila Bhattacharyya, and Samilia Obeng-Gyasi.

Critical revision of the article: Ahamd Hamad, Yaming Li, Allan Tsung, Bridget Oppong, Mariam Eskander, Oindrila Bhattacharyya, and Samilia Obeng-Gyasi.

Corresponding author

Correspondence to Samilia Obeng-Gyasi.

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Ethical Approval Statement

For this type of study, formal consent is not required.

Ethics Approval

The Ohio State University Office of Responsible Research Practices deemed this study IRB exempt.

Consent to Participate

This study was a retrospective review of a National Cancer database and no consent to participate was required.

Consent for Publication

This study was a retrospective review of a National Cancer database and no consent to publish study results was required.

Conflict of Interest/Competing Interests

The authors declare no competing interests.

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Supplementary Information

ESM 1

Unadjusted and adjusted examination of differences in survival by race (DOCX 15 kb)

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Hamad, A., Li, Y., Tsung, A. et al. Hispanic Ethnicity and Breast Cancer: Disaggregating Surgical Management and Mortality by Race. J. Racial and Ethnic Health Disparities 9, 1568–1576 (2022). https://doi.org/10.1007/s40615-021-01096-3

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  • DOI: https://doi.org/10.1007/s40615-021-01096-3

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